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

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalAsian Journal of Surgery
DOIs
Publication statusAccepted/In press - 2019 Jan 1

Fingerprint

Large-Core Needle Biopsy
Therapeutics
Pseudoangiomatous stromal hyperplasia
Diagnostic Imaging
Physical Examination
Breast
Growth
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Yoon, Kwang Hyun ; Koo, Bonyong ; Lee, Kwan Beom ; Lee, Haemin ; Lee, Jeea ; Kim, Jee Ye ; Park, Hyung Seok ; Park, Seho ; Kim, Seung Il ; Cho, Young Up ; Park, Byeong Woo. / Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast. In: Asian Journal of Surgery. 2019.
@article{a1fdfdcb1dbd4f11a8a63d39873220eb,
title = "Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast",
abstract = "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.",
author = "Yoon, {Kwang Hyun} and Bonyong Koo and Lee, {Kwan Beom} and Haemin Lee and Jeea Lee and Kim, {Jee Ye} and Park, {Hyung Seok} and Seho Park and Kim, {Seung Il} and Cho, {Young Up} and Park, {Byeong Woo}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.asjsur.2019.09.008",
language = "English",
journal = "Asian Journal of Surgery",
issn = "1015-9584",
publisher = "Elsevier Taiwan LLC",

}

Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast. / Yoon, Kwang Hyun; Koo, Bonyong; Lee, Kwan Beom; Lee, Haemin; Lee, Jeea; Kim, Jee Ye; Park, Hyung Seok; Park, Seho; Kim, Seung Il; Cho, Young Up; Park, Byeong Woo.

In: Asian Journal of Surgery, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast

AU - Yoon, Kwang Hyun

AU - Koo, Bonyong

AU - Lee, Kwan Beom

AU - Lee, Haemin

AU - Lee, Jeea

AU - Kim, Jee Ye

AU - Park, Hyung Seok

AU - Park, Seho

AU - Kim, Seung Il

AU - Cho, Young Up

AU - Park, Byeong Woo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85074432696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074432696&partnerID=8YFLogxK

U2 - 10.1016/j.asjsur.2019.09.008

DO - 10.1016/j.asjsur.2019.09.008

M3 - Article

AN - SCOPUS:85074432696

JO - Asian Journal of Surgery

JF - Asian Journal of Surgery

SN - 1015-9584

ER -