Can anyone explain exactly what Pseudoangiomatous stromal hyperplasia (PASH) is?

cabbott said:

PASH
When surgeons operate on a breast, they send sample of the cells to the pathologist who classifies the cells in a report. They often find a lot of different kinds of cells. Sometimes the cells are malignant (cancer). Sometimes they are benign (not cancer). Sometimes they are normal. Malignant or cancer cells are normal cells that have gone crazy. Under the microscope you can tell that they are cancer because their shape is irregular, their nuclei are irregular, and they are invading the tissue that surround them. Benign tissues form masses that don't invade the surrounding tissue and they don't look so wildly messed up. Sometimes benign cells are not a problem but sometimes they could be a problem. PASH is a very rare finding. From what I could find out, it usually presents itself as a lump in the breast. It is benign but it has a tendency to grow and reoccur if not totally removed. When removed, the lump is more or less regular in shape and has not invaded the surrounding tissue. If the breast is full of PASH cells, then a mastectomy might be needed. If the lump is all in one place, then a lumpectomy would be needed unless the lump was very large. One article I found used tamoxifen with a patient whose tumor reoccurred, but most seemed to use just surgery. Here is a link to a medical article on PASH if you wish to read it: http://www.jfponline.com/Pages.asp?AID=4704 .


When I was first diagnosed, the pathologist found lots of different kinds of cells in my biopsy sample. I looked every single one of them up and wondered what they all meant. My surgeon told me that some were normal findings, some were commonly associated with a high risk of cancer, and one was ductal carcinoma. That last one means cancer. He pointed out that was the only one I needed to be concerned about. I never forgot about the other cells since one kind meant I may experience cancer again on the other side...but sure enough only the ductal carcinoma on the right had to have treatment at that time. That was back in 2002 and so far so good!

If you have PASH and cancer, you will probably be told to just concentrate on the cancer too. If you only have PASH, you will have to concentrate on how you want to get rid of it. It sounds like you already had a mastectomy, so it may be that you have already done everything you could to get rid of the problem. Followup appointments to make sure it stays gone should be put in place and you may also want to consult a knowledgeable breast oncologist especially since this is a rare finding. Good luck!

cinnamonsmile said:

After finding info about it
After finding info about it and asking my surgeon, she said the only thing to do with PASH is to remove it or it will keep growing and growing. She said it can get so bad that the breast will become totally enlarge like a baskeball. But then again, everyone's tumors are different. Yours may never grow. I opted for a BMX and that's how they found it was PASH. I didn't want to go through biopsy, lumpectomy etc. Just take both breasts. I would get a second opinion on PASH. I wouldn't trust the nurses opionion after what my surgeon told me.It's only been known since the 80s.

Here's some links with info:

http://www.ncbi.nlm.nih.gov/pubmed/7872425

http://breast-cancer.ca/type/pseudoangiomatous-stromal-breast-hyperplasia.htm

cinnamonsmile said:

Interesting mom42, my PASH
Interesting mom42, my PASH did not show up on a mammogram either! It showed up on my presurgical MRI. My surgeon was a general surgeon who specializes in breast cancer, if that makes any sense I hope you get all the information you can and find someone who doesn't just brush it off so you can make a good decision on what to do.