Diabetic mastopathy - A clinicopathologic review

Diabetic mastopathy, an uncommon form of lymphocytic mastitis and stromal f ibrosis, typically occurs in longstanding type 1 diabetes. Nineteen cases m eeting predetermined histopathologic criteria for diabetic mastopathy were correlated as to clinical history and disease recurrence. Physical examinat ion revealed palpable discrete masses or diffuse nodularity both predominan tly in the subareolar region. One nonpalpable lesion was detected incidenta lly, during reduction mammoplasty. All cases contained lymphocytic ductitis and lobulitis with varying degrees of keloidal fibrosis, vasculitis, epith elioid fibroblasts, and lymphoid nodule formation. Single mammary lesions w ere found in 11 patients with type 1 diabetes, 1 with type 2 diabetes, and 3 without diabetes. Four cases were bilateral (3 patients with type 1 and 1 patient with type 2 diabetes). Six of 19 cases recurred (3 ipsilateral, 2 contralateral, and 1 bilateral). We confirm the histopathologic constellati on for diabetic mastopathy However, we question the specificity of these fe atures because of identical findings in patients with type 2 diabetes and n ondiabetic patients. We found diabetic mastopathy in men and women, as a so litary mass or bilateral disease, and recurrence in either breast, sometime s multiple. Recognition of potential recurrence is important because it mig ht spare patients with documented diabetic mastopathy from repeated breast biopsies.