Endocrine Abstracts

Introduction: Diabetic mastopathy (DM) is a rare benign fibroinflammatory disease of the breast with the prevalence of 0.6–13%^, seen in long standing Type 1 diabetes who may have other diabetes related complications. Its also been described in patients with type II diabetes, autoimmune diseases such as Hashimoto’s thyroiditis. The term lymphocytic mastopathy in used interchanged due to the histopathology and for patients without diabetes. It presents in men and women presents as a solitary mass or bilateral disease. Both the clinical features and the imaging characteristics of DM can mimic those of invasive breast cancer. Lymphocytic mastitis with or without diabetes mellitus may represent a lymphoepithelial lesion of the MALT-type which is considered to bear a prelymphomatous potential. Diagnosis is complex, and biopsy of the lesion is often necessary to establish a proper lesion classification. Here, we report a case of Diabetic mastopathy.

Clinical Presentation: 31 years old type 1 diabetic woman G1P1 presenting with right painless breast lump for 3 weeks duration. She has no other comorbidities other than long standing Type 1 DM and has been on Insulin Aspidra + Lantus. She is 11 months postpartum and stopped breastfeeding 4 months ago. On clinical examination she appeared normal built, normal general Physical examination; breast examination right subaeroelar hard mobile painless irregular nodule of 2 cm, no skin or nipple changes or lymphadenopaty. She was evaluated with bloods and usg breast. The Usg breast showed dense glandular tissue with 2 cm subaereolar lump appeared benign in nature. She was reviewed after 6 weeks for a repeat scan which showed 3 cm right ill defined mass with low echogenecity. She had a core biopsy which reported lymphocytic infiltration and fibrosis compatible with the diagnosis of diabetic mastopathy.

Discussion: Diabetic mastopathy is a rare benign breast lesion. It poses a clinical dilemma due to similarities of presentation with breast malignancy it can lead to additional investigations and surgery. Dm is seen with other diabetic complications such as neuropathy, retinopathy or nephropaty. Although our patient had long standing type 1 diabetes she did not have any other related diabetic complications. It can be diagnosed with the help of radiological imaging but as it may mimic invasive cancer. Core-needle biopsy remains to be a gold standard. In difficult cases complementary imaging methods such as ultrasound, mammography, and MRI should be used. This is important to confirm the diagnosis and to avoid any risk of missing early breast cancer. DM patient can be managed symptomatically and excision is not necessary in asymptomatic patients.