BREAST SARCOIDOSIS MIMICKING BREAST CANCER: A CASE REPORT

Abstract

Sarcoidosis is a systemic granulomatous condition of idiopathic etiology, predominantly affecting the lungs and mediastinal lymph nodes in approximately 90% of cases, with mammary involvement being extremely rare, occurring in less than 1% of reported occurrences. Objective: To report a case of breast sarcoidosis. Case description: In this study, we describe a case of mammary sarcoidosis in a 74-year-old patient, previously asymptomatic, who presented with nonspecific symptoms such as asthenia, diffuse abdominal pain, fatigue, weight loss, and respiratory symptoms over the course of one month. Imaging studies, including mammography, breast ultrasound, and chest computed tomography, revealed a dense nodule in the right breast, bilateral nodular and heterogeneous images, as well as bronchial wall thickening, multiple small calcified nodules bilaterally, and enlarged lymph nodes in the mediastinum and pulmonary hilum. Histopathological analysis of the mammary nodules, through biopsy and immunohistochemistry, confirmed a non-necrotizing chronic granulomatous inflammatory process, suggesting sarcoidosis as the primary diagnostic hypothesis. Treatment was initiated with prednisone at a dose of 0.5 mg/kg/day, resulting in significant clinical and radiological improvement. Discussion: Mammary involvement in sarcoidosis can be the initial site of the disease, manifesting as a palpable mass or being incidentally discovered. It is crucial to distinguish mammary sarcoidosis from malignancy or other inflammatory conditions. Thus, it is important to consider sarcoidosis as a differential diagnosis in patients with breast nodules, even though rarely observed, aiming for early detection and better prognosis.