Women with long-standing insulin-dependent diabetes mellitus (IDDM) and radiographically dense mammary glandular tissue can have benign breast masses clinically resembling cancer. The authors have identified 36 patients, aged 20-54 years, with this little-known condition, which the authors call diabetic fibrous breast disease (DFBD). For a diagnosis of DFBD, the patient must fulfill certain stringent requirements: a long-term history of IDDM; radiographically dense glandular tissue; and one or more hard, irregular, easily movable, discrete, painless, palpable breast masses with strong ultrasonographic acoustical shadowing and firm resistance to the back-and-forth motion of the needle used for fine-needle aspiration cytology (FNAC). Patients meeting all criteria can be monitored with serial FNAC procedures to prevent them from undergoing multiple surgical biopsies. During an average of 6 years of monitoring these 36 women, breast cancer did not develop in any mass fulfilling all requirements for DFBD.
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