Sarcoidosis of the Breast

Abstract

The clinical manifestation of breast sarcoidosis accounts for <1% of cases of sarcoidosis and typically presents in the setting of already documented systemic involvement. Within the breast, sarcoidosis can often present as a firm palpable mass in young or middle-aged women. On mammography, imaging findings range from small, well-defined round masses to irregular, spiculated masses. Ultrasound most commonly demonstrates an ill-defined hypoechoic mass. As a result, breast sarcoidosis can mimic benign and malignant pathologies such as fat necrosis, fibroadenoma or breast cancer. This variability in imaging appearance represents a diagnostic challenge often culminating in image-guided or surgical biopsy and histological analysis to establish a definitive diagnosis. Ultimately, while breast involvement is uncommon, it accentuates the diverse clinical manifestations of sarcoidosis, which may be clinically suspected and must be adequately evaluated to exclude more significant pathologies.