Abstract
Pseudo angiomatous stromal hyperplasia (PASH) is a benign breast lesion rarely presented as palpable lesion. It's a myofibroblastic proliferation of the breast, which represents localized form of stromal overgrowth with hormonal etiology (primarily progesterone). Microscopically, PASH consists of a network of slit-like spaces lined by myofibroblasts that resembles vascular space. It's not true vascular space; it is the disruption and separation of stromal collagen fibers, not like low grade angiosarcoma sarcoma, which is characterized by anastomotic vascular channels with invasion into breast parenchyma. It's important to differentiate it histologically from low grade angiosarcoma. PASH lacks the invasive features with no destruction of mammary epithelial structures. It is not a premalignant lesion and is common in gynecomastia. Core-needle biopsy is accurate. Mimicking low grade angiosarcoma histologically may lead to unnecessary radical surgery. Surgical excision is the treatment for localized lesions. This prospective study was conducted to assess the local recurrence rate post-surgical excision with rarity of PASH as palpable breast lesion. Only 3 cases were collected and followed up for variable duration; the longest was 5 years. None of them developed local recurrence post-surgical excision.