Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast
Summary: Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast. Owing to the rarity of PASH, the pathogenesis, clinical manifestation, and optimal treatment of this condition remain unclear. We aimed to clarify the appropriate management...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-07-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958419308127 |
| _version_ | 1818279790225915904 |
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| author | Kwang Hyun Yoon Bonyong Koo Kwan Beom Lee Haemin Lee Jeea Lee Jee Ye Kim Hyung Seok Park Seho Park Seung Il Kim Young Up Cho Byeong-Woo Park |
| author_facet | Kwang Hyun Yoon Bonyong Koo Kwan Beom Lee Haemin Lee Jeea Lee Jee Ye Kim Hyung Seok Park Seho Park Seung Il Kim Young Up Cho Byeong-Woo Park |
| author_sort | Kwang Hyun Yoon |
| collection | DOAJ |
| description | Summary: Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast. Owing to the rarity of PASH, the pathogenesis, clinical manifestation, and optimal treatment of this condition remain unclear. We aimed to clarify the appropriate management of PASH. Methods: We performed a retrospective analysis of the clinicopathological data of 66 cases with a diagnosis of PASH, confirmed by core needle biopsy (CNB) or surgical excision at Severance Hospital between 2000 and 2016. The primary endpoint was pathologic results after surgical excision of the lesion that confirmed PASH by CNB. The secondary endpoint was progression after the first treatment. Result: The median age of patients was 41 years (range, 14–61 years). Findings on medical imaging were nonspecific. CNB was performed in 61 cases, with a diagnosis of PASH confirmed in 39 cases (63.9%). No malignant or premalignant cells directly arising from PASH were identified after surgical excision that confirmed PASH via CNB. The progression rate after the first treatment was 16.6%, with lesion size, enlargement of palpable mass size, and a diagnosis other than PASH on CNB being factors associated with progression. Conclusion: CNB is sufficient to confirm PASH what is necessary for an abnormal imaging or suspicious physical examination finding. Surgical excision is not necessarily indicated to rule out occult malignancy after a diagnosis of PASH. Close monitoring or surgical excision are required to manage large lesions (>3 cm) or progressive growth of a PASH lesion. |
| first_indexed | 2024-12-12T23:38:55Z |
| format | Article |
| id | doaj.art-1df247985b444ce38643c63343fec8ff |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-12T23:38:55Z |
| publishDate | 2020-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-1df247985b444ce38643c63343fec8ff2022-12-22T00:07:16ZengElsevierAsian Journal of Surgery1015-95842020-07-01437735741Optimal treatment of pseudoangiomatous stromal hyperplasia of the breastKwang Hyun Yoon0Bonyong Koo1Kwan Beom Lee2Haemin Lee3Jeea Lee4Jee Ye Kim5Hyung Seok Park6Seho Park7Seung Il Kim8Young Up Cho9Byeong-Woo Park10Department of Surgery, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Republic of KoreaDepartment of Surgery, U&U Surgery Clinic, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaDivision of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Corresponding author. Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. Fax: +82 2 2228 4140.Division of Breast Surgery, Department of Surgery, Breast Cancer Center, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of KoreaSummary: Background: Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast. Owing to the rarity of PASH, the pathogenesis, clinical manifestation, and optimal treatment of this condition remain unclear. We aimed to clarify the appropriate management of PASH. Methods: We performed a retrospective analysis of the clinicopathological data of 66 cases with a diagnosis of PASH, confirmed by core needle biopsy (CNB) or surgical excision at Severance Hospital between 2000 and 2016. The primary endpoint was pathologic results after surgical excision of the lesion that confirmed PASH by CNB. The secondary endpoint was progression after the first treatment. Result: The median age of patients was 41 years (range, 14–61 years). Findings on medical imaging were nonspecific. CNB was performed in 61 cases, with a diagnosis of PASH confirmed in 39 cases (63.9%). No malignant or premalignant cells directly arising from PASH were identified after surgical excision that confirmed PASH via CNB. The progression rate after the first treatment was 16.6%, with lesion size, enlargement of palpable mass size, and a diagnosis other than PASH on CNB being factors associated with progression. Conclusion: CNB is sufficient to confirm PASH what is necessary for an abnormal imaging or suspicious physical examination finding. Surgical excision is not necessarily indicated to rule out occult malignancy after a diagnosis of PASH. Close monitoring or surgical excision are required to manage large lesions (>3 cm) or progressive growth of a PASH lesion.http://www.sciencedirect.com/science/article/pii/S1015958419308127BreastPseudoangiomatous stromal hyperplasia of the breastCore needle biopsySurgical procedures |
| spellingShingle | Kwang Hyun Yoon Bonyong Koo Kwan Beom Lee Haemin Lee Jeea Lee Jee Ye Kim Hyung Seok Park Seho Park Seung Il Kim Young Up Cho Byeong-Woo Park Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast Asian Journal of Surgery Breast Pseudoangiomatous stromal hyperplasia of the breast Core needle biopsy Surgical procedures |
| title | Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast |
| title_full | Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast |
| title_fullStr | Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast |
| title_full_unstemmed | Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast |
| title_short | Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast |
| title_sort | optimal treatment of pseudoangiomatous stromal hyperplasia of the breast |
| topic | Breast Pseudoangiomatous stromal hyperplasia of the breast Core needle biopsy Surgical procedures |
| url | http://www.sciencedirect.com/science/article/pii/S1015958419308127 |
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