Sarcoidosis and breast cancer: A retrospective case series

Abstract

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.

Sarcoidosis and maligancy: the chicken and the egg?

“…However, because of closer oncologic follow-up in these patients compared to general population, it remains unclear whether sarcoidosis is merely a coincidental finding or if a true association between previous malignancy and this disorder exists. In a minority of the Papinikolaou and Shigemitsu study cohort [32], as well as in other experiences from literature [31], sarcoidosis preceded breast cancer, but the time interval was considerably longer compared to that between the diagnosis of breast cancer and subsequent sarcoidosis, making a clear association less likely. However, the occurrence of axillary lymph node involvement in sarcoidosis poses a diagnostic challenge in the differentiation of sarcoidosis from suspected breast metastasis to the lymphatic system and warrants further investigations in all cases.…”

“…Sarcoidosis was diagnosed after breast cancer by an average of 4.3 years, and it was usually asymptomatic affecting lungs and central lymph nodes without serious organ involvement. Specific treatment was required in approximately half of cases [32].…”

Clinical Reasoning: New-Onset Diplopia and Headache in a Patient With Metastatic Breast Cancer

“…In the case of malignancy, SLRs are usually asymptomatic and most often affect lymph nodes draining the tumor or the involved organ itself 13 . However, overt sarcoidosis (and neurosarcoidosis) may occur with malignancy, including breast cancer which usually-but not always-precedes the sarcoidosis diagnosis 14 .…”

Rare Form of Breast Cancer and Lung Foci: Do We Always Have to Wait for Metastases?

“…По данным литературных источников, саркоидоз в основном возникает вскоре после постановки диагноза или лечения РМЖ, с классическими признаками поражения грудной клетки или внутригрудных лимфоузлов [5][6][7]. В исследовании, включившем 429 пациенток с саркоидозом, общая распространенность РМЖ составила 4,6% (20 случаев) [8]. Более чем у 50% больных диагноз саркоидоза был поставлен в течение 5 лет после возникновения РМЖ [9].…”