The 411 on Diabetes and… Mastopathy

This is National Breast Cancer Awareness Month, and all across the country people are sharing various ways to “Save the ta-tas!”

Well, that mantra doesn’t just apply to cancer. There’s something else the ta-tas need saving from: diabetes.

Diabetic mastopathy is one of the more uncommon effects of diabetes, and it’s rarely included in warning lists of potential diabetes complications. But it’s real and it happens, so we’re going to talk about it and give you the scoop as part of our 411 on D-complications series (with a new icon!).

First of all, Googling the term “diabetic mastopathy” pulls up some pretty scary images… (yes, that’s a warning!). But the stats help calm the nerves a bit.

Occurring in about 13% of pre-menopausal women with type 1 diabetes, dabetic mastopathy is a benign (see: noncancerous) “fibrous breast mass.” It mostly occurs in women (and sometimes men) who already have a pre-existing diabetes complication, like kidney disease or neuropathy.

Several websites list “long-standing diabetes” as criteria as well, but that’s a fairly loose term. Websites that do list a time frame usually say that women who’ve had diabetes 15-20 years or longer are at highest risk. However, that association might only exist because older women are the ones encouraged to self-monitor their breasts, and are more likely to discover a problem.

Diabetic mastopathy is also a fairly recent discovery, with the first report of it appearing in 1984. So there isn’t that much known about the condition. Recent DOC forums are full of women asking questions and sharing stories, but it doesn’t appear that diabetic mastopathy is getting much attention from researchers, so these women are often left with very vague answers.

We’ll try to help a bit.

Why the Boobs?

Little information exists to support any particular cause for diabetic mastopathy. But the main theory goes something along the lines of a mass developing in breast tissue because of high blood sugars. As mentioned, patients with diabetic mastopathy often have other diabetic complications, too.

One theory is that some kind of immune reaction happens in response to insulin injections. One report suggests that because type 2 patients who are on insulin can also get diabetic mastopathy, it must be related to injected insulin. Of course, this theory is unsubstantiated, and considering type 2 PWDs can also have high blood sugar, it may be a bit of a stretch to think the insulin is to blame. Maybe it’s just the high blood sugar itself creating that mass in the breast tissue.

In short, the research doesn’t tell us much at all at this point.

Signs of D-Mastopathy

Like breast cancer, this condition feels like a small, hard lump in the breast tissue that isn’t tender to the touch. For the most part, diabetic mastopathy is not painful. It can occur in a variety of patterns, from multiple lumps to a solitary lump in the breast, and it can occur in both breasts or just one.

“I found my lump in July, and by November, I realized it had grown in size significantly, so I made an appointment with my gynecologist,” says Lee Ann Thill, 39, a DOC blogger and art therapist who was diagnosed with diabetic mastopathy when she was 27 years old. “There was no pain or any other symptoms.  It was a palpable lump that grew from pea-sized to apricot-sized in just a few months.”

Lee Ann points out that age isn’t a factor with diabetic mastopathy, just duration of diabetes. She wants young adults with type 1, especially those who’ve had it for many years, to know they can also be at risk.

If you find yourself with a lump, get yourself to a oncologist quickly! Diabetic mastopathy is indistinguishable from breast cancer by touch and most imaging technology can’t detect the difference either. In fact, it is often confused with breast cancer and can lead to unnecessary surgeries.

A core biopsy can usually determine whether or not it is a malignant mass. This kind of procedure allows a doctor to remove tissue from the breast without surgery, which makes it a less invasive option (though local anesthesia is required).

Although diabetic mastopathy is benign, breast cancer isn’t. So if you find a lump and have had diabetes for several decades, don’t brush it off as diabetic mastopathy. Breast cancer is much more common! However, being aware that diabetic mastopathy is a risk can help patients avoid unnecessary procedures, so make sure your doctor is educated.

What Can Be Done?

According to the scientific literature, there’s no treatment for diabetic mastopathy (!). This doesn’t go away on its own, and the lump or lumps can continue to grow over the years, as a female with diabetes (FWD) gets older.

Actually, surgically removing the lumps is an option, but reports indicate that there’s a 32% chance that they will regrow within five years of the surgery. Surgeries also increase scar tissue in the breasts, which can then make it difficult to detect mastopathy and breast cancer later on.

Ann Bartlett, a PWD in Washington, DC, was diagnosed with diabetic mastopathy in 2008 after nearly 20 years of living with lumps in her breast. She was in her twenties at the time, and doctors were not concerned with the lumps, believing they couldn’t be cancer. Now in her 40s, she gets biannual mammograms, despite the fact that mammograms can be difficult to use in diagnosing mastopathy.

Ann wrote on her blog, “While some people feel mammograms for diabetic mastopathy are pointless, what they offer my breast care team is a consistent history for looking for change.  It’s one part of a three-part routine check up: look and feel, mammography and ultrasound, and last resort biopsy.”

If you already have diabetic mastopathy and find new lumps, you need to get checked out again. Although having diabetic mastopathy does not appear to put you at an increased risk for breast cancer, it’s better to be safe than sorry. Just because you already have one fibrous lump does not guarantee every lump will always be the same thing, although mastopathy lumps are not cancerous and will never turn into cancer.

So there you go.

Diabetes can ruin your boobs, too. If that’s not a reason to find a cure, I don’t know what is.