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Diabetic mastopathy

Case contributed by Noriza Zainol Abidin
Diagnosis certain

Presentation

Case of insulin dependent diabetes mellitus, presented with painless right breast lump for 2 years duration.

Patient Data

Age: 40 years
Gender: Female
mammography

Breast density pattern: Type B (Heterogenous breast parenchyma). Ill-defined dense mass located at right upper outer quadrant. However, no architectural distortion or suspicious clustered microcalcification.

Benign right axillary node.

Ultrasound breasts

ultrasound

Complementary ultrasound shows ill defined heterogenous hypoechoic lesion with strong posterior shadowing, seen at right breast upper outer quadrant. No significant increased vascularity on color doppler study.

Impression:
Right breast upper outer quadrant heterogenous lesion with sonographic strong posterior shadowing (BIRADS 3). In view of underlying diabetes, findings suggestive of diabetic mastopathy.
Patient subjected for ultrasound guided biopsy as this findings mimicking malignancy.

Histopathology

The core biopsy specimen reveals fibrotic stroma with rare groups of nonneoplastic breast acini and periductal lymphocytic infiltrates. No in situ or invasive malignancy present. Histopathological findings consistent with diabetic mastopathy.

Case Discussion

Diabetic mastopathy is a rare benign entity, should be considered in premenopausal young women with breast lump in underlying long standing insulin dependent diabetes mellitus.

In view of clinical and radiological similarities with malignancy, histopathological confirmation is necessary to established the diagnosis.

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