A 33-year-old woman with type I DM noted the presence of a non-tender mass in the left breast that had been slowly growing in size over six months. Although she claimed adherence to insulin since being diagnosed, there was objective evidence of poor endocrine control. In addition, her history revealed a diagnosis of diabetic retinopathy and several HbA1c values >8.0%. Clinical examination revealed a 2 cm non-tender lump in the upper outer quadrant of the left breast. In addition, the mass was firm, mobile, and not associated with skin or nipple changes.
The figure shows that breast ultrasonography revealed an ill-defined mass with posterior solid acoustic shadowing. Therefore, an excision biopsy was performed. As shown in the figure, the excised mass was firm and irregular on the gross inspection with a solid white cut surface. Microscopic analysis revealed breast tissue with no evidence of malignancy. Nevertheless, there was marked fibrosis and keloid-like hyalinization of the interlobular stroma, entrapment of adipose tissue and ducts and lobules compression. In addition, there was a thick chronic periductal and per lobular inflammatory cell infiltration associated with lymphoid follicle formation.
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