Diabetic Mastopathy: A Case Report and Literature Review

Abstract

Diabetic mastopathy is a rare fibroinflammatory breast disease characterized by lymphocytic lobulitis, ductitis, and perivasculitis with stromal fibrosis. This lesion often presents as a discretely palpable uni- or bilateral mass in long-standing type I diabetes and other autoimmune diseases. We report a case of insulin-dependent diabetic mastopathy, which presented clinically as an indeterminate breast lump suspicious for malignancy. The patient is a 36-year-old woman who had type 1 insulin-dependent diabetes mellitus. Mammography and ultrasonography raised a suspicion of malignancy, and an excisional biopsy was performed. A previous biopsy had shown no evidence of malignancy. Histopathological examination now showed dense keloid-like stromal fibrosis with epithelioid-like and spindly myofibroblasts and a characteristic lymphocytic infiltration around blood vessels in and around lobules and ducts, features consistent with diabetic mastopathy. The literature is briefly reviewed.

Diyabetik Lenfositik Meme İltihabı: Malignitenin Klinik-Görüntüleme Taklitçisi

“…The patient reported by us had no such associated complications. DLM has also been reported in patients with type 2 diabetes as well as those with thyroid diseases and also in men 3 .…”

Spindle cell lesions of breast: a retrospective analysis with emphasis on diagnostic challenges

“…7 Diabetic mastopathy is a rare fibroinflammatory disease of breast seen in diabetic women of pre-menopausal age. 8,9 It is thought to result from the resistance to collagen degradation in persons with diabetes. This uncommon fibrous proliferation may mimic a neoplasm as it clinically presents as single or multiple nontender firm to hard mass.…”

Diabetic mastopathy: a case report

“…The accumulation of abnormal matrix and advanced glycosylated end products acts as neoantigens and triggers an autoimmune response with B-cell proliferation and autoantibody production. Subsequent macrophage-mediated advanced glycosylation end-product removal and cytokine release may act as growth factors and induce additional matrix expansion and proliferation of collagen [2][3][4]. Since fibrous tissue deposition and collagen proliferation in the breast are similar to that of other diabetic complications, it is not unlikely that some patients with DMP will have thyroid, eye, and joint involvement due to their long-standing insulin-dependent diabetes [8].…”

“…DMP should be considered in the differential diagnosis of breast cancer but it is not a premalignant disease. As the disease can be managed conservatively but may recur, an accurate diagnosis is essential to avoid unwanted multiple surgical biopsies [3,6].…”

“…The disease is associated with long-standing type 1 insulin-dependent diabetes mellitus (IDDM) but has also been reported in other autoimmune disorders and in type 2 diabetes mellitus [3,4].…”