One Lump or Two?
Unexpected diabetes complication masquerades as cancer scare
March 2007 — When I found a lump in my left breast, diabetes was the furthest thought from my mind.
It was a common answer to many of my medical ailments; from headaches to a bout with pancreatitis, diabetes was usually the culprit. In my early thirties, I lay in bed, shaking with the fear of the unknown. The lump was the size of a pea, hard and unyielding. I barely slept that night, and called the clinic for an appointment.
My doctor told me that I had fibrous breasts and dense tissue. She sent me to have an ultrasound of the breast, which, according to the doctors, showed "nothing out of the ordinary". I was in the process of moving back from Europe, so I accepted the diagnosis and moved on. (I realize now that I was putting off the inevitable.)
The lump grew in size from a pea to a peach pit. I knew that this wasn't normal, but I was afraid. Afraid that "nothing out of the ordinary" was anything but that. My new doctor told me that I needed to have a mammogram. I told him that I needed a new breast that wasn't lumpy.
The mammogram was quick, relatively painless, and unbeknownst to me, the cause of severe distress in another room. My friend was the mammogram technician, and while we were laughing minutes before about the stylishness of the clinic gowns, she was crying as she viewed what she thought was my large malignant tumor on the monitor.
I was ushered into an ultrasound area, where additional scans of my breast created more tension. A few minutes later, a brusque radiologist came into the room and, without greeting me, announced: "Based on your mammogram and ultrasounds, according to my experience, you have breast cancer. We'll schedule a biopsy and then you can discuss your options with your physician."
I don't remember how I got home or how I got through the next few days before the core needle biopsy. Due to the fibrous nature of the lump, the doctor and staff had difficulty collecting tissue samples. I left the office with a frozen bag of peas for the swelling (yes, frozen peas – sometimes they give you frozen corn), a single rose from the clinic staff, and a million questions swirling in my head. My loving family and friends worried with me while we waited for the diagnosis. When it came, we were shocked.
Diabetes struck again. It was not cancer. (Thanks, Dr. Radiologist, for your expert diagnosis. We needed a good scare.)
Diabetic fibrous mastopathy is an uncommon complication for pre-menopausal women with longstanding type 1 diabetes. While much rarer, it can affect men and women with type 2 diabetes. All studied cases show the unifying factor seems to be the usage of insulin and poor glycemic control. It's often accompanied by another complication (retinopathy, nephropathy, or neuropathy), although in my case, I had not developed any other complications at that time.
Benign lumps of varying sizes emerge in the breast area. They do not go away or disappear. We talked with surgeons about the possibility of removing the lump, but research showed that in many cases, the lumps return, so excising them is not always the best option.
Over the course of that year, I developed a lump in my right breast, and another core needle biopsy confirmed diabetic fibrous mastopathy again. I have yearly mammograms to ensure that no additional masses are growing, and if so, there will be more biopsies in my future. In the meantime, I have matching lumps.
Why do I share this? How many other diabetic women have stared at the ceiling, wondering if a lump would change their lives? My lump did. I had never heard of diabetic fibrous mastopathy before I was diagnosed with it. Sharing my story might let one woman know that she's not alone - and to talk with her diabetes team to get a mammogram – even if she's under the age of 35.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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