Is Surgical Excision Necessary in Pseudoangiomatous Stromal Hyperplasia?

Layon, Daniel R.; Wang, Caroline; Roth, Susan Orel; Brooks, Ari D.

doi:10.1111/tbj.12643

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Incompletely excised PASH can recur in up to 22% of cases and can be managed with reexcision [ 6 ]. No additional interventions are required for incidentally diagnosed PASH in concordant core biopsies [ 1 , 2 , 7 ]. Sufficient data on the efficacy of medical management is unavailable; as until now, only anecdotal case reports have demonstrated the possible efficacy of antihormonal therapy in preventing PASH progression [ 6 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Tiger-Striped PASH: Recognition of a Unique Morphology Allows for a Zippered-Up Diagnosis of Pseudoangiomatous Stromal Hyperplasia of Breast

Sakibuzzaman

Kendziora

Ghosh

et al. 2021

Case Reports in Pathology

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Pseudoangiomatous stromal hyperplasia (PASH) of the breast is histologically characterized by anastomosing and slit-like spaces invested by collagenous stroma and lined by flattened, spindle cells. These clear spaces that may mimic microscopic vascular channels do not contain red blood cells. Immunohistochemistry (IHC) studies may also help to confirm a diagnosis of PASH, with the spindled cells marking positively with CD34 and PR while demonstrating no reactivity with more specific endothelial antigens such as CD31 and ERG. In the current case, a 39-year-old female was diagnosed with cellular PASH of the right breast with unique histological patterns showing “tiger-striped” and “zippered” histologies. To our knowledge, this is the first report of these unique variant PASH morphologies.

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Section: Discussionmentioning

confidence: 99%

“…Pseudoangiomatous stromal hyperplasia (PASH) is a relatively infrequent, benign, proliferative breast condition [ 1 , 2 ]. PASH is a spindle-cell proliferation that pathologically originates from collagen-producing myofibroblasts [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Tiger-Striped PASH: Recognition of a Unique Morphology Allows for a Zippered-Up Diagnosis of Pseudoangiomatous Stromal Hyperplasia of Breast

Sakibuzzaman

Kendziora

Ghosh

et al. 2021

Case Reports in Pathology

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“…The radiological appearance is similar to that of fibroadenoma and the diagnosis is made by percutaneous core biopsy (e25). If there is evidence of a tendency to grow, or a discrepancy between clinical findings, imaging findings, and histology, extirpation with wide margins should be carried out; if the tumor is progressive, this could mean complete mastectomy (27). For PASH discovered incidentally on biopsy without any corresponding clinical or imaging findings, ultrasound follow-up will suffice, as the risk of breast cancer is not increased (28).…”

Section: Detection Of Fibroadenomasmentioning

confidence: 99%

Benign Breast Disease in Women

Stachs

Stubert²,

Reimer³

et al. 2019

Deutsches Ärzteblatt International

112

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Background: Most clinical breast changes in women are benign; in only 3% to 6% of cases are they due to breast cancer. However, there is a lack of up-to-date, evidence-based treatment recommendations for the various benign differential diagnoses.Methods: Selective literature search of PubMed from 1985 to May 2019, including current national (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften [Association of Scientific Medical Societies in Germany]) and international guidelines.Results: Mastalgia and fibrocystic changes are common (around 50% of all women over the age of 30). Fibroadenomas occur in 25% of women; they are the most common benign tumors of the breast and do not require treatment. With most benign breast changes the risk of dedifferentiation is very low. However, it is important in the differential diagnosis to distinguish between such benign changes and breast cancer or changes that carry a risk of malignancy. Complex cysts, for example, carry a risk of malignancy of 23% to 31%, papillary lesions 16% , and radial scars 7%. Where there is doubt, histological confirmation should be sought by means of percutaneous biopsy. Conclusion:Benign breast changes can be definitively distinguished from malignant lesions through the selective use of available diagnostic investigations and interdisciplinary collaboration. When lesions of uncertain malignant potential are found (B3 in the biopsy classification), complete excision is indicated. Prospective studies on the early diagnosis of breast cancer in lesions carrying a risk of malignancy are desirable.

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“…PASH is preferentially managed by close interval follow-up in the absence of pathologically and radiologically suspicious cancerous or precancerous features. However, in cases of rapid lesion growth or suspicious radiologic features, surgical excision should be considered [16] , [17] . The treatment of diffuse tumorous PASH such as the present case depends on clinical factors and is challenging because of the rarity of the presentation.…”

Section: Discussionmentioning

confidence: 99%

Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia treated with bilateral mastectomy in a 40-year-old woman

Koh

2018

Radiology Case Reports

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Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast disease characterized by breast stromal proliferation mimicking low grade angiosarcoma. PASH is frequently detected as an incidental component coexisting with other breast lesions. However, it can also present as a single localized mass and is typically unilateral. Mammographic and sonographic findings are nonspecific and indistinguishable from those of benign lesions. We report an unusual case of PASH presenting with diffuse enlargement of the bilateral breasts in a 40-year-old woman treated with bilateral mastectomy.

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Is Surgical Excision Necessary in Pseudoangiomatous Stromal Hyperplasia?

Cited by 7 publications

References 5 publications

Tiger-Striped PASH: Recognition of a Unique Morphology Allows for a Zippered-Up Diagnosis of Pseudoangiomatous Stromal Hyperplasia of Breast

Tiger-Striped PASH: Recognition of a Unique Morphology Allows for a Zippered-Up Diagnosis of Pseudoangiomatous Stromal Hyperplasia of Breast

Benign Breast Disease in Women

Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia treated with bilateral mastectomy in a 40-year-old woman

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