Diabetic Mastopathy Mimicking Malignancy: A Surgical Perspective on Diagnosis and Management

Diabetic Mastopathy (DMP) is an uncommon benign fibroinflammatory condition of the breast, predominantly seen in individuals with long-standing diabetes mellitus. It often mimics malignancy on clinical and radiological examination, leading to diagnostic uncertainty. DMP accounts for 0.5-13.5% of all benign breast lesions. Here, authors present the case of a 48-year-old postmenopausal female who presented with complaints of serous, cheesy discharge of minimal quantity from the right nipple, intermittently for the past 10 years, along with pain over the right breast for the last four weeks. Clinical evaluation revealed a firm, tender subareolar mass with nipple-areola distortion and cheesy discharge. Imaging via sonomammography revealed a Breast Imaging Reporting and Data System 3 (BIRADS 3) hypoechoic lesion with cystic areas and ductal dilatation. A wide local excision, including the removal of the distorted nippleareola complex, was performed. Gross and histopathological examination showed fibrocystic changes with dense fibrous stroma, lymphoplasmacytic infiltration and giant cells, consistent with DMP. Close clinical follow-up is essential. Heightened clinical awareness and individualised treatment strategies can help minimise unnecessary surgeries while ensuring patient safety and reassurance.