Sarcoidosis and breast cancer: A retrospective case series

Background: Sarcoidosis and breast cancer co-incidence is reported in the literature in the form of case reports. Aim: To describe our experience from a single large sarcoidosis clinic. Methods: Retrospective chart review of 1000 sarcoidosis cases seen in our clinic from 2003 to 2008. Results: 429/1000 female sarcoidosis cases were identified. Among them 20/429 had a history of sarcoidosis and breast cancer. In 12/20 breast cancer preceded sarcoidosis by 52 months, in 4/20 sarcoidosis preceded breast cancer by 200 months and in 4/20 they presented concurrently. Mean age of sarcoidosis diagnosis was 53.9 (+/- 12.4) years. Majority were of European decent (16/20), 3 were African-Americans and 1 Asian. Scadding radiography stages distribution was (n) 4/11/3/2/0 for stages 0/I/II/III/IV respectively. They had 3.4 (+/- 1.3) organs involved, mainly with intrathoracic involvement. 10/20 were asymptomatic and 11/20 received chronic treatment. Compared to 409 cases of sarcoidosis sine breast cancer (mean age 46.7 +/- 13.1), sarcoidosis-breast cancer cases had sarcoidosis diagnosed at a significantly later age (p = 0.01). Histological diagnosis applied in all co-incidence cases, in 5 via mediastinoscopy. Conclusions: Older females with breast cancer may develop sarcoidosis, with features indistinguishable from stand-alone sarcoidosis. When sarcoidosis is suspected histological diagnosis is mandatory.