DIABETIC MASTOPATHY IN A PATIENT WITH TYPE 1 DIABETES MELLITUS

Abstract

INTRODUCTION/BACKGROUND
Diabetic mastopathy is a rare fibroinflammatory condition that predominantly affects long-standing type 1 diabetes mellitus. It commonly presents as firm and painless breast masses, mimicking malignancy. The diagnosis is often based on clinical evaluation, imaging studies and pathological correlation. While the exact pathophysiology remains unclear, it is hypothesized to involve an autoimmune mechanism, leading to lymphocytic infiltration and stromal fibrosis in the breast tissue.

CASE
We present the case of a 30-year-old primigravid at 16 weeks of gestation, with a background of poorly controlled long-standing type 1 diabetes mellitus complicated by diabetic nephropathy and retinopathy. She presented with a painless lump in her left breast. Clinical examination found a 3 × 2 cm mass in the upper outer quadrant of the left breast, which was firm, mobile and non-tender. There were no overlying skin changes. Breast ultrasound revealed multiple irregular hypoechoic masses with pronounced posterior shadowing. Histopathological examination (HPE) of the mass showed dense stromal keloidal type fibrosis with moderate lymphocytic infiltration around the periductal, peri-lobular and perivascular regions. The diagnosis of diabetic mastopathy was made, and reassurance was given to the patient.

CONCLUSION
Diabetic mastopathy is a benign self-limiting breast lesion with a high risk of recurrence after surgical intervention, hence it generally does not require treatment. The awareness of this rare condition may avoid unnecessary surgical intervention, mental distress, as well as diagnostic uncertainty.