Sarcoidosis is a benign systemic granulomatous pathology of unknown etiology. Mammary involvement is rare, less than 1% of all cases. That is the reason that makes necessary an optimal differential diagnosis to rule out malignant pathology as the main diagnosis. Imaging tests such as mammography, ultrasound, or MRI contribute to the diagnosis but are unable to establish a certain diagnosis. When a mammary sarcoidosis is suspected by fine needle aspiration cytology, exceptional procedures are necessary to confirm the disease and to exclude a coexisting carcinoma. Malignancy may develop in patients with sarcoidosis, sarcoidosis may develop in patients with breast cancer, the two diseases may develop in tandem, or breast cancer may cause a sarcoidosis-like granulomatous response. Other illnesses that should rule out are granulomatous diseases, which could be differentiated into infectious causes such as tuberculosis and primary inflammatory diseases such as idiopathic granulomatous mastitis. The silicone of gel breast implants may originate a sarcoidosis-like reaction as the result of an acceleration of an already existing hypersensitivity response, resulting in breast sarcoidosis. The management of sarcoidosis in the breast is usually enough with an excisional biopsy. The prognosis of mammary sarcoidosis in not unknown.
Part of the book: Sarcoidosis