A breast lump that scares a doctor and the patient equally: unexpected and complicated surgical consequences of long-standing diabetes

  • R. Ponniah Iyyappan
  • Anjana Vasudevan
  • T. H. BhuvaneswariEmail author
  • V. Rajasenthil
  • C. Kaliyappa
  • P. Senthilkumar
Original Article



This study analyzes a number of diabetic mastopathy cases in long-standing type 1 diabetes to obtain a detailed history and examination findings from these patients and to reach a possible conclusion of arriving at the diagnosis.

Subjects and methods

A 10-year retrospective study was done from January 2008 to December 2018 on patients who attended the diabetic outpatient department diagnosed for type 1 diabetes mellitus and presented with breast complaints. Complete history and examination of all these patients were noted. The collected data were analyzed with IBM SPSS Statistics software version 16.0.


All of the patients had a similar presentation and had undergone excision biopsy of the lump. Histopathology examination reports have confirmed a diagnosis of diabetic mastopathy. The clinical and imaging findings are inconclusive and these lesions are often misdiagnosed as breast carcinomas.


The recognition of this rare but benign disease is crucial to avoid surgical biopsies, which are performed more often than necessary.


Breast tumor Surgical consequences Long-standing diabetes Diabetic mastopathy 



The authors acknowledge the support and help provided by Sri Ramachandra Institute of Higher Education and Research, Chennai, India (IEC/PG/16/Dec/07/44).

This article has not been submitted, published, or presented previously to any journal. The results of a pilot study (not a completed research work) were presented in conference proceedings as an abstract.

Compliance with ethical standards

Informed consent

As per the institutional review board, this study did not require any informed consent from patients directly. The institutional review board approved the study and data were collected retrospectively from a clinical database.

Human rights

The study “A breast lump that scares a doctor and the patient equally: unexpected and complicated surgical consequences of long-standing diabetes” was conducted in agreement with the institutional ethical review board of Sri Ramachandra Institute of Higher Education and Research, Chennai, India (CSP/17/June/49/2017). This study did not require informed consent from patients.

Sample statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and/or with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute was not required to be obtained from patients included in the study.

Conflict of interest

The authors do not have anything to disclose and declare no conflict of interest.

Financial support and sponsorship

No financial support was obtained for this research.


  1. Akahori H, Kaneko M, Kiyohara K, Terahata S, Sugimoto T (2009) A rare case of diabetic mastopathy in a Japanese man with type 2 diabetes mellitus. Intern Med 48:915–919CrossRefGoogle Scholar
  2. Barr RG, Zhang Z (2012) Effects of precompression on elasticity imaging of the breast: development of a clinically useful semiquantitative method of precompression assessment. J Ultrasound Med 31:895–902CrossRefGoogle Scholar
  3. Campos GC, Castro MV, de Mattos VF, Pinto LZ, Boechat MC, Dos Santos AA (2014) Lymphocytic mastopathy mimicking breast malignancy: a case report. Radiol Bras 47:256–258CrossRefGoogle Scholar
  4. Christiaensen E, Jacquemyn Y, Verslegers I, Van Goethem M, Van Marck V (2009) Axillary lymphadenopathy as a first symptom of diabetic mastopathy. BMJ Case Rep 2009;bcr03.2009.1703Google Scholar
  5. Honda M, Mori Y, Nishi T, Mizuguchi K, Ishibashi M (2007) Diabetic mastopathy of bilateral breasts in an elderly Japanese woman with type 2 diabetes: a case report and a review of the literature in Japan. Intern Med 46:1573–1576CrossRefGoogle Scholar
  6. Isomoto I, Wada T, Abe K, Uetani M (2009) Diagnostic utility of diffusion-weighted magnetic resonance imaging in diabetic mastopathy. Clin Imaging 33:146–149CrossRefGoogle Scholar
  7. Kim J, Kim EK, Kim MJ, Moon HJ, Yoon JH (2016) Diabetic mastopathy: imaging features and the role of image-guided biopsy in its diagnosis. Ultrasonography 35:140–147CrossRefGoogle Scholar
  8. Kirby RX, Mitchell DI, Williams NP, Cornwall DA, Cawich SO (2013) Diabetic mastopathy: an uncommon complication of diabetes mellitus. Case Rep Surg 2013:198502PubMedPubMedCentralGoogle Scholar
  9. Kudva YC, Reynolds C, O’Brien T, Powell C, Oberg AL, Crotty TB (2002) “Diabetic mastopathy,” or sclerosing lymphocytic lobulitis, is strongly associated with type 1 diabetes. Diabetes Care 25:121–126CrossRefGoogle Scholar
  10. Membrilla E, Jimeno M, Martínez M, Maria Corominas J, Solsona J, Grande L (2009) Diabetic mastopathy in diabetes mellitus type 2. Endocrinol Nutr 56:43–46CrossRefGoogle Scholar
  11. Miura K, Teruya C, Hatsuko N, Ogura H (2012) Autoantibody with cross-reactivity between insulin and ductal cells may cause diabetic mastopathy: a case study. Case Rep Med 2012:569040CrossRefGoogle Scholar
  12. Neetu G, Pathmanathan R, Weng NK (2010) Diabetic mastopathy: a case report and literature review. Case Rep Oncol 3:245–251CrossRefGoogle Scholar
  13. Sankaye S, Kachewar S (2012) Diabetic mastopathy. Australas Med J 5:296–299PubMedPubMedCentralGoogle Scholar
  14. Soler NG, Khardori R (1984) Fibrous disease of the breast, thyroiditis, and cheiroarthropathy in type I diabetes mellitus. Lancet 1:193–195CrossRefGoogle Scholar
  15. Thanarajasingam U, Chen B, Tortorelli CL, Jakub JW, Ghosh K (2011) Diabetic mastopathy as a radiographically occult palpable breast mass. Case Rep Med 2011:162350CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • R. Ponniah Iyyappan
    • 1
  • Anjana Vasudevan
    • 1
  • T. H. Bhuvaneswari
    • 1
    Email author
  • V. Rajasenthil
    • 1
  • C. Kaliyappa
    • 1
  • P. Senthilkumar
    • 2
  1. 1.General SurgerySri Ramachandra Institute of Higher Education and ResearchPorur, ChennaiIndia
  2. 2.General Surgery DepartmentKanyakumari Government Medical CollegeKanyakumariIndia

Personalised recommendations