I've had 3 breast biopsies over the last 20 years. The first one was in 1991. I started noticing a hard lump for months and finally decided that rather than leave it to chance, I would talk to a doc. I was immediately referred to a surgeon who took it out and assured me it was just fibrous tissue. It was until 2003, that I had the second and 18 months ago, the third. Last week, I went in for my biannual mammogram and once again they said, "The margins are just so hard to read" and I was promptly scheduled for another core needle biopsy, this week.
What does all of this mean? For women with diabetes, both type1 and type2 we have a tendency to develop thickening of the tissue. It happens due to fluctuating blood glucose, some of which we can control, but some is the nature of the Diabetic beast! It's called Diabetic Mastopathy and it is not a precancerous issue, but a concern since the technicians can't clearly identify all the lumps they are left to figure out if there is a concern. Diabetic mastopathy tends to appear in women who have had diabetes for more than 16 years. I have the double whammy of fiber cystic breasts anyway, so why not add more that makes the screen almost black when they ultra sound!
For most of us, diabetic mastopathy is a benign problem, but it definitely needs to be watched. Two years ago, my ultra sound and mammograms were so hard to read that they bumped me up to twice yearly and I believe it was a good decision! I don't have breast cancer in my family, but the fact is nothing is a given, so stay on top of it.
Here's my advice on talking with your ob/gyn, or HPC:
1) Teach them. I had been dealing starting mammograms when I was 35 and no one said, "Diabetic mastopathy until 5 years ago. I looked up and called my breast clinic to ask to speak to the radiologist. Even my breast oncologist was reluctant to peg that diagnosis until the radiologist upped her education! Don't get angry, just be the educated patient and work with them.
2) Don't be afraid to look at the screens and understand as much as you can. Last week, I was having the ultra sound and the radiologist left to bring in a colleague. At first they hesitated, but I said to them, "I'm in this with you. The more I know, the more I can be helpful and I'm it also eases any fear." So they pointed out the one lump that had weird margins and gave me another example of clear margins. But they were quick to point out that the margins did not read like cancer. For me, this was fascinating about what my body is doing under the skin.
3) Needles. Anesthesia? If you are given the option, I prefer core needle biopsy, as it creates less scar tissue.
It is hoped, both by my doctor and myself, that after menopause the lumpiness will decrease. I'm also hoping to have breast reduction, but have decided to wait because I don't want to increase scar tissue. After menopause things should improve and I can revisit reduction at that time.
I have written about diabetic mastopathy, but thought I would update my recent: