Diabetic Mastopathy In Iraqi patients; Modalities Of Diagnosis And Management Options

Khairi Toman, Ali

	Diabetic Mastopathy In Iraqi patients; Modalities Of Diagnosis And Management Options
Kerbala Journal of Medicine
Article 1, Volume 7, Issue 1, 2014, Pages 1797-1805 PDF (0 K)
Author
Ali Khairi Toman
Abstract
background: Diabetic fibrous mastopathy, also known as lymphocytic mastitis, is an un common lesion of the breast that occurs in women with long standing insulin dependent diabetes mellitus (IDDM) It is a distinct clinicopathologic entity with specific histopathological characteristics, which include keloid fibrosis, epithelioid fibroblast, widespread periductal/lobular lymphocytic infiltration and widespread perivascular lymphocytic infiltration. Objective: To confirm that: (a) Many diabetic patients can be spared from undergoing multiple, unwarranted surgical biopsies (b) Mastopathy can happen even in NIDDM, (c) Diabetic mastopathy can co-exist with malignant breast lesions. Patients And Methods: A study for 48 patients with palpable breast masses. The patients are divided into 3 groups: Group A (10 patients): contain the patients with long standing IDDM. Group B (14 patients): contain the patients with NIDDM. Group C (24 patients): contain age matched control non-diabetic patients selected with clinical finding similar to that present in diabetic mastopathy. FNAC, ultrasound and mammographic examinations were done before proceeding for excisional biopsy. Results & Discussion: We found that 7 out of 10 patients in Group A (70%) have features suggesting of diabetic mastopathy and only 4 out of 14 patients in group B (28.5%) and (0%) in group C, have the same features. So we demonstrate that, diabetic mastopathy could be the only cause of palpable breast mass in diabetic patients. Diabetic mastopathy is a distinct clinicopathologic entity with specific histopathological features, which include keloid fibrosis, epithelioid fibroblast, widespread Periductal/lobular lymphocytic infiltration and widespread perivascular lymphocytic infiltration. Our work confirmed the presence of the histopathological characteristics of diabetic mastopathy in palpable breast masses in long standing IDDM (group A). We also observed the presence of the histopathological characteristics of diabetic mastopathy in breast tissue in mastectomy specimens away from intraductal and infiltrating ductal carcinoma in NIDDM (group B). Conclusion: we should have awareness that this entity exists and a careful correlation of the patient history with physical, radiological and cytological examination should be applied.
Keywords
Diabetic mastopathy; fibrous mastopathy; lymphocytic lobulitis

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