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Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast

 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 
 ASIAN JOURNAL OF SURGERY, Vol.43(7) : 735-741, 2020-07 
Journal Title
Issue Date
Adolescent ; Adult ; Angiomatosis / diagnosis ; Angiomatosis / pathology* ; Angiomatosis / surgery* ; Biopsy, Large-Core Needle* ; Breast ; Breast Diseases / diagnosis ; Breast Diseases / diagnostic imaging ; Breast Diseases / pathology* ; Breast Diseases / surgery* ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Hyperplasia / diagnosis ; Hyperplasia / pathology* ; Hyperplasia / surgery* ; Magnetic Resonance Imaging ; Middle Aged ; Monitoring, Physiologic ; Young Adult
Breast ; Core needle biopsy ; Pseudoangiomatous stromal hyperplasia of the breast ; Surgical procedures
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Il(김승일)
Park, Byeong Woo(박병우) ORCID logo https://orcid.org/0000-0003-1353-2607
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
Lee, Kwanbum(이관범)
Lee, Jeea(이지아) ORCID logo https://orcid.org/0000-0003-3145-2205
Lee, Haemin(이해민)
Cho, Young Up(조영업) ORCID logo https://orcid.org/0000-0003-2936-410X
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