Diabetic Fibrous Mastopathy: Case Reports and Radiologic-Pathologic Correlation

Diabetic fibrous mastopathy, an unusual finding in patients with early onset, long-standing insulin dependent diabetes, can present as a palpable mass with mammographic and sonographic findings highly suggestive of breast cancer. These suspicious clinical and imaging findings necessitate a biopsy, which demonstrates characteristic findings of dense, keloid scarring and intralobular lymphocytic infiltrates. We present 2 cases of diabetic fibrous mastopathy with characteristic mammographic, sonographic, and pathologic findings diagnosed with ultrasound guided core needle biopsy and confirmed with surgical excision. In the appropriate clinical setting, a patient with long-standing insulin dependent diabetes with a firm, mobile breast mass and characteristic sonographic findings of a hypoechoic mass with lobulation and marked posterior acoustic shadowing should suggest the possibility of diabetic fibrous mastopathy. Awareness of this entity may obviate the need for surgical excision in patients whose clinical, imaging, and pathologic findings are consistent with diabetic fibrous mastopathy.