Diabetic mastopathy: Clinical presentation, imaging and histologic findings, and treatment

Abstract

ObjectiveDiabetic mastopathy is an uncommon complication of longstanding diabetes mellitus that must be considered in the differential diagnosis with breast cancer. We report the clinical presentation and course, the imaging and histologic findings, and the treatment of the patients diagnosed with diabetic mastopathy at our hospital. Material and methodsIn an 11-year period, we studied six insulin-dependent diabetic patients (five women and one man) with diabetic mastopathy. Imaging studies included mammography, ultrasonography, and magnetic resonance imaging. A definitive histologic diagnosis was reached after core needle or surgical biopsy in all cases. Fine-needle aspiration cytology was not used in any of the cases. The mean follow-up period was 7years. ResultsThe most common clinical presentation was a palpable nodule (67%). The imaging findings were (a) at mammography: asymmetrical density (50%), (b) at ultrasonography: a solid, hypoechoic nodule measuring between 1cm and 5cm in diameter, with ill-defined margins, acoustic shadowing, and no Doppler signal (50%), and (c) at MRI: enhancement after the administration of contrast media (66%). The most common histologic finding was lymphocytic mastitis in the initial stages (83%). All patients underwent surgical treatment (100%). ConclusionsDiabetic mastopathy is an uncommon disease that should be included in the differential diagnosis with breast cancer in diabetic patients. The diagnosis is complex because it requires knowledge of the patient's history, clinical presentation, and the imaging and histologic findings; conservative surgery is the treatment of choice because the condition does not respond to medical treatment.