To analyze the diagnosis and treatment of diabetic mastopathy (DM) and summarize the characteristics of DM based on literature review.

A retrospective analysis was performed in 52 patients with pathologically confirmed DM in Tianjin Cancer Hospital from September 2011 to June 2021. The clinical data of these patients were collected to analyze their clinical manifestations, imaging features and pathological results.

All patients were female, with the age of 62(59, 68) years. Fifty patients had diabetes (96.15%, 50/52), of which 94.00% (47/50) had type 2 diabetes. The follow-up period was 40.7 (22.5, 46.0) months. Palpable breast masses were observed in 51 patients (98.08%, 51/52), mostly with firmness, unclear border, no tenderness and poor mobility. Breast X-ray revealed indeterminate, localized and dense breast parenchyma in 38 patients(79.17%, 38/48), with benign calcifications or well-defined mass areas in some cases. The ultrasound manifestation of DM ranged from localized thickening of the glands to undefined masses, with uneven echoes, irregular shapes, and structural derangement. Most of them were at the grade of BI-RADS 4-5 (88.64%, 39/44). Breast MRI shows non-mass-type enhancement lesions, indicating the possibility of breast cancer. All patients underwent biopsy by tumor resection or aspiration. The pathological features were fibrosis of the breast stroma, accompanied by ductal inflammation and lobular inflammation, even lymphocyte infiltration in some cases. Lymphocyte or inflammatory cell infiltration were observed in 19 cases, which was significantly correlated with the comorbidity of other autoimmune diseases (P=0.007).

DM was a rare benign breast lesion, with clinical and imaging manifestations similar to breast cancer. For patients with breast masses and diabetes, biopsy by tumor resection or aspiration is recommended for a clear histopathological diagnosis.