“Diabetic Mastopathy,” or Sclerosing Lymphocytic Lobulitis, Is Strongly Associated With Type 1 Diabetes

Abstract

OBJECTIVE -To demonstrate the strong association of diabetic mastopathy or sclerosing lymphocytic lobulitis with type 1 diabetes mellitus by studying appropriate control groups and to describe risk factors and natural history of the disorder.RESEARCH DESIGN AND METHODS -This was a retrospective cross-sectional study of four groups of patients conducted at a setting tertiary care medical center. We examined benign breast biopsies (investigator masked to identity) from age-matched patients with types 1 and 2 diabetes, autoimmune thyroid disease, or none of the above disorders for sclerosing lymphocytic lobulitis. Several risk factors proposed for the disorder (age at diagnosis of benign breast disease, duration of diabetes, age at onset of diabetes, prevalence of retinopathy, neuropathy, nephropathy and cheiroarthropathy, glycemic control, parity, oral contraceptive use, menopausal status, or number of breast biopsies) were evaluated, and patients were contacted to describe the natural history of the disorder.RESULTS -Sclerosing lymphocytic lobulitis was identified in 69.7% of the subjects with type 1 diabetes and 1.8% of those with autoimmune thyroid disease diagnosed with benign breast disease at surgery. It did not occur in patients with type 2 diabetes with or without insulin treatment or in control subjects. Only retinopathy and peripheral neuropathy were associated with sclerosing lymphocytic lobulitis. Breast carcinoma or lymphoma did not occur subsequently in any type 1 diabetes patient with or without sclerosing lymphocytic lobulitis.CONCLUSIONS -Sclerosing lymphocytic lobulitis is strongly associated with type 1 diabetes. Retinopathy and neuropathy are associated with the disorder. The risk of malignancy is not increased. Diabetes Care 25:121-126, 2002

Regression of the fibrous disease of the breast in a non-diabetic woman after pregnancy and breastfeeding

“…Still, the surgical excision of the lesion was not indicated to the patient given that, approximately, 1/3 of the lesions tends to recur after excision (9), generally in the same location of the excision, five years after initial appearance (26). The follow-up of the lesion shall be done even though there is no evidence of increased risk of neoplasia or lymphoma in breast tissue affected by fibrous mastopathy (10,27,28). However, Mackey et al (3) described the presence of breast carcinoma arising within the mastopathy in a woman submitted to a renal transplant.…”

Lobulite Linfocitária Esclerosante Em Pacientes Com Diabetes Mellitus Tipo 1

“…As pacientes geralmente são jovens e muitas delas, porém nem todas, apresentam diabetes do tipo 1 de longa duração. Por outro lado, cerca de 70% das pacientes com diabetes do tipo 1 desenvolvem a doença 8 . Nesses casos, normalmente várias complicações da diabete já estão presentes na época da detecção do nódulo mamário, como retinopatia diabética, neuropatia e nefropatia 11 .…”

“…Lesões similares podem aparecer em homens com diabetes melitus do tipo 1 de longa evolução, e são consideradas uma forma especial de ginecomastia 5 . A mastopatia diabética não está associada ao diabetes do tipo 2 8 . No exame mamográficos as lesões aparecem como áreas densas assimétricas, podendo haver espessamento da pele subjacente 12 .…”

“…Vários nomes já foram propostos para essa condição: doença fibrosa da mama do diabetes do tipo 1 2 , mastopatia do diabetes insulino dependente 3 , doença mamária fibrosa diabética 4 , mastite linfocítica com fibrose 5 , mastopatia fibrosa diabética 6 e mastopatia diabética 7 . O termo lobulite linfocitária esclerosante é o mais aceito atualmente porque, conforme será discutido adiante, nem todas as pacientes que apresentam essas lesões mamárias são diabéticas 1,8 .…”

Diabetic Mastopathy in an Elderly Woman: A Case Report

“…Type II diabetes often have endogenous hyperinsulinemia and only patients on exogenous insulin developed diabetic mastopathy, suggesting that exogenous insulin use may be related to diabetic mastopathy. In type I diabetes, Kudva et al 15) reported that diabetic mastopathy development is not associated with the use of insulin or degree of glycemic control and patients with sclerosing lymphocytic lobulitis show significantly higher prevalence of retinopathy and neuropathy. On the contrary, Tomaszewski et al 2) described that diabetic mastopathy without epithelioid fibroblasts showed no secondary diabetic changes.…”