Diabetic Mastopathy, or Lymphocytic Lobulitis

  • Diabetic mastopathy, or lymphocytic lobulitis:
    • Is a benign condition found in premenopausal women:
      • With long-standing type 1 diabetes mellitus
    • Patients usually present with:
      • firm, painless, irregular, suspicious mass in one or both breasts
    • Mammograms often show:
      • Dense fibroglandular tissue but no discrete mass
    • Ultrasound usually shows:
      • An ill-defined hypoehoic area with shadowing
    • Core needle biopsy:
      • Is the preferred technique to make the diagnosis
    • The pathologic findings are typically:
      • Glandular atrophy
      • Lymphocytic / mononuclear perivascular inflammation:
        • Which is predominantly B-cell
      • Dense, often keloid-like fibrosis:
        • With or without epithelioid-like fibroblasts
    • If the lesion is well-sampled and the pathology is concordant with the imaging:
      • There is no need for excision because it is not a premalignant lesion
    • In fact, up to 60% of diabetic mastopathy recurs after excision:
      • Therefore, surgical excision is not recommended
    • The etiology may be:
      • An autoimmune reaction:
        • To accumulated matrix related to hyperglycemia
    • Once diagnosed:
      • Patients should be aware of changes in their breasts and have any new lumps evaluated
    • Well-controlled blood sugar:
      • Is advocated as diabetic mastopathy often presents in patients with other complications of diabetes such as:
        • Retinopathy
        • Neuropathy
        • Nephropathy
      • Otherwise, there is no known treatment
  • References:
    • Camuto PM, Zetrenne E, Ponn T. Diabetic mastopathy: a report of 5 cases and a review of the literature. Arch Surg. 2000;135(1):1190-1193.
    • Neetu G, Pathmanathan R, Weng NK. Diabetic mastopathy: a case report and literature review. Case Rep Oncol. 2010;3(2):245-251.
    • Thorncroft K, Forsyth L, Desmond S, Audisio RA. The diagnosis and management of diabetic mastopathy. Breast J. 2007;13(6):607-613.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #DiabeticMastopathy # LymphocyticLobulitis

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