Breast disease in sarcoidosis

Background: Breast disease in sarcoidosis can be classified as sarcoidosis patients with breast granulomas, sarcoidosis patients with breast cancer, a nd breast cancer patients displaying sarcoidosis-like breast reactions. Met hods: We reviewed the medical records of 629 women with sarcoidosis followe d in the Interstitial Lung Disease Clinic at the University of Cincinnati f or findings associated with breast disease. In addition, three women with b reast cancer who had granulomas in proximity to their tumors were also exam ined. Results: Abnormal breast examinations or mammograms were reported in 15 patients with sarcoidosis (2% of women with sarcoidosis). Breast biopsy revealed granulomas consistent with sarcoidosis in six. One of them develop ed breast cancer five years later. Breast cancer was identified in twelve f urther patients, therefore a total of thirteen patients with breast cancer were identified. Ten were diagnosed with breast cancer plus sarcoidosis: sa rcoidosis, preceded breast cancer in three, followed breast cancer in five, the two diseases appeared simultaneously in two. Three additional women wi th breast cancer were also evaluated and classified as patients with sarcoi d-like reaction. Review of the mammographic and physical findings could not distinguish between sarcoidosis in the breast and breast cancer. Conclusio n: Sarcoidosis patients develop breast cancer at the expected frequency. Th e breast cancer diagnosis may precede or follow that of sarcoidosis. There is no relationship between stage of sarcoidosis or treatment and the develo pment of cancer. Because physical examination and mammography findings are unable to distinguish between sarcoidosis and malignancy, biopsy of all sus picious lesions in sarcoidosis is recommended.