Diabetic mastopathy: An entity clinically mimicking malignancy; review of a series of three cases

Diabetic mastopathy is an unusual lesion affecting the breast of patients with longstanding diabetes mellitus (DM). This lesion presents as large hard masses, leading to clinical suspicion of malignancy, and may result in unnecessary surgeries. It is characterized histopathologically by sclerosing lymphocytic mastitis. During 1-year period from January 2016 to December 2016, we came across three cases of sclerosing lymphocytic mastitis. All were females with longstanding DM and presented with palpable, nontender, hard breast masses. Clinical impression was malignancy. They underwent imaging studies, fine needle aspiration cytology, and core needle biopsies before excision biopsy. The specimens consisted of firm-to-hard fibrotic masses with a grayish-white cut surface. Histopathology showed characteristic keloid-like sclerosing fibrosis, dense perilobular and intralobular lymphocytic infiltrates. Clinicopathological correlation will resolve these cases in most instances and aid in preventing radical surgical procedures. Imaging studies however may not be helpful in all cases.