Diabetic Mastopathy

Diabetic mastopathy is a benign fibrous breast disease associated with long standing type 1 diabetes.

• Premenopausal women, 20 to 40 years, often with other microvascular complications or autoimmune disease (thyroiditis).
• Histology: dense keloid like stromal fibrosis, lymphocytic lobulitis, epithelioid fibroblasts; likely autoimmune.
• Recurs in up to 30% of excisions; no increased cancer risk.

• Hard, irregular, painless breast mass (single or multiple, uni or bilateral).
• Mimics carcinoma clinically and radiographically.

• Mammography: dense; ultrasound: hypoechoic with posterior shadowing.
• Core needle biopsy is diagnostic and avoids excision.
• MRI may be needed for equivocal results.
• Exclude malignancy; concordance of imaging and pathology is essential.

• Conservative management after biopsy confirmation: observation, no surgery.
• Excision only for symptoms or discordance; high recurrence.
• Optimise glycaemic control and manage other complications.
• Routine breast cancer screening per age.