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.