Fibrous mastopathy: clinical, imaging, and histopathologic findings of 31 cases.
OBJECTIVE
The aim of this study was to analyze the cases of patients with a histological diagnosis of fibrous mastopathy, diabetic mastopathy, or lymphocytic mastopathy in association with other autoimmune diseases, and to conduct histological and imaging studies as well as follow up of the lesions.


METHODS
Thirty-one patients meeting predetermined histopathological criteria for diabetic mastopathy, fibrous mastopathy, or lymphocytic mastopathy were analyzed for several factors: age at diagnosis; clinical manifestations; parity; breastfeeding; use of sex steroids for hormonal replacement therapy or hormonal contraception; associated diseases; mammographic findings; breast magnetic resonance imaging and ultrasound; histological and cytological diagnosis; immunohistochemical and immunophenotyping identification of T- and B-lymphocytes and macrophages, and alpha-smooth muscle actin; and follow up.


RESULTS
Fibrous mastopathy was present among diabetic and non-diabetic patients, patients with autoimmune diseases, and healthy individuals. Relapses were found in one-quarter of the lesions and spontaneous regression was observed in one case. There was a predominance of T-lymphocytes over B-lymphocytes in the fibrous mastopathic lesions (P < 0.001). Macrophages were demonstrated in 95.2% of the lesions. All of the lesions displayed reactivity for alpha-smooth muscle actin, a characteristic of myofibroblasts.


CONCLUSIONS
Fibrous mastopathy does not occur in diabetic patients only; fibrous mastopathy may also occur in healthy subjects; the lesion is characterized by a higher number of T-lymphocytes over B-lymphocytes, the presence of absolute lobular lymphocytic infiltrate, reactivity for alpha-smooth muscle actin, and macrophages. Relapses were found in one-quarter of the lesions and spontaneous regression was observed in one case.
Pereira
Maria Aparecida de Queiroz Freitas
MA
Mastology Unit, Hospital de Base do Distrito Federal, Brazil.
de Magalhães
Albino Verçosa
AV
da Motta
Lucilia Domingues Casulari
LD
Santos
Ana Maria de Souza
AM
Segura
Marcos Emanuel de Alcântara
ME
Pereira
Camila Freitas
CF
Casulari
Luiz Augusto
LA
D000328:Adult; D000368:Aged; D001940:Breast / Q000378:metabolism / Q000473:pathology*; D001942:Breast Feeding; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005348:Fibrocystic Breast Disease / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018579:Patient Selection; D012008:Recurrence; D012307:Risk Factors; D016217:Ultrasonography, Mammary