Section: Breast Curriculum: Curriculum, page 9 and Curriculum, page 9
Definition
- A rare benign breast lesion, often forming a mass
- Benign myofibroblastic proliferation of non-specialised mammary stroma
Incidence
- Can be seen in teens to elderly; Mean age ≈ 47
- In males: reported in 63% of cases of gynaecomastia
- In females: present as an incidental finding in up to 23% of excised specimens
Aetiology & Pathology
- Importance lies in the skills of the pathologist to distinguish it from malignancy
- Pathogenesis - ? aberrant reactivity of myofibroblasts to endogenous or exogenous hormones
Clinical
- Often form a fibroadenoma-like mass
- Ix: Triple assessment → Bx
Management
- It is benign
- Does not require excision or f/up if otherwise bengin features on imaging
- However it is usually hard to differentiate from malignancy
- If suspicious features on imaging and biopsy of PASH then surgical excision should be performed as this biopsy should bot be accepted
- Excision is adequate treatment if a pt is anxious and for infrequent recurrences
Prognosis / Natural Hx
- Infrequently recurs