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.

Keywords: Breast cancer; Interstitial lung diseases; Sarcoidosis.

Fig. 1

Column graph of age distribution of sarcoidosis patients in our study and ASSESS study [9]. Sarcoidosis and breast cancer cases (green color) and those who developed sarcoidosis after breast cancer (purple) swift to the right of the ascending age scale, contrary to our total sarcoidosis population (red) which resembles historic ASSESS data (blue). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)