Type of publication:
Conference abstract
Author(s):
*Cane C.L.; *Jones A.M.; *Moulik P.K.
Citation:
Diabetic Medicine. Conference: Diabetes UK Professional Conference 2024. London . 41(Supplement 1) (no pagination), 2024. Date of Publication: 01 Apr 2024.
Abstract:
A 26-year-old nulliparous female presented with a 2-week history of a right breast lump. She had type 1 diabetes for 17 years and polycystic ovaries. Her diabetes distress led to suboptimal glycaemic control. There was firm tissue under the right nipple-areola complex, and ultrasound (US) demonstrated a suspicious 43-mm mixed echogenic lesion with posterior shadowing (U4). Core biopsy revealed marked fibrosis with fibroblasts and entrapped benign breast ducts and adipose tissue. Breast ducts were highlighted by epithelial markers (AE1/3 and small P63), blood vessels by CD34, and fibroblasts and myoepithelial layers by smooth muscle actin (SMA). She was reassured; 2 years later she developed a left breast lump and 26-mm focal hypoechoic glandular lesion on US, right breast lesion unchanged. A diagnosis of DMP was made. DMP occurs in 20- to 40 year-old women with long duration of type 1 diabetes. It can occur in men rarely. It presents with a painless, hard, mobile breast lesions which are irregular. Bilateral lesions develop in 50% patients. Axillary lymphadenopathy is absent. Mammography reveals dense glandular tissue and US shows acoustic shadows behind the lesion. Core biopsy is recommended. DMP is a benign condition which may raise concerns of breast cancer. It may be associated with autoimmunity and occasionally seen in insulin treated type 2 diabetes, systemic lupus erythematosus and Hashimoto's. Microscopy shows periductal, perilobular and perivascular B-lymphocytic infiltrates with some T cells, fibroblast proliferation and collagen. Management is conservative unless a larger lesion requires excision. To date, only one case report has been published on breast cancer in a patient with DMP.
DOI: 10.1111/dme.15295
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