Breast Sarcoidosis Management: A Case Report and Review of the Literature

Sarcoidosis is a systemic granulomatous inflammatory disease of unclear pathogenesis, predominantly affecting northern Europeans and occurring more commonly in females and non-smokers. Breast involvement in sarcoidosis is rare, often confused with malignant lesions, and typically diagnosed incidentally. This report presents a case of a breast lump initially suspected to be a recurrent abscess, later confirmed as sarcoidosis. A 27-year-old breastfeeding mother presented with a large, painful right breast lump three months postpartum (P2G0). Initial imaging suggested an abscess or galactocele. Despite incision, drainage, and antibiotics, the mass recurred. Further surgical intervention and biopsy revealed non-caseating granulomas, consistent with sarcoidosis. Systemic involvement was ruled out through comprehensive imaging and laboratory tests, leading to a diagnosis of Löfgren's syndrome. The patient was treated with systemic steroids and hydroxychloroquine, resulting in significant improvement and symptom resolution. Breast sarcoidosis is often diagnosed incidentally owing to screening programmes. The literature review highlights the importance of tissue biopsy for definitive diagnosis, as clinical and radiological features are non-specific. Misdiagnosis with tuberculosis (TB) is common due to overlapping presentations. The relationship between sarcoidosis and cancer remains complex, with some studies suggesting an increased risk of malignancy in sarcoidosis patients. Breast sarcoidosis, though rare, should be considered in the differential diagnosis of breast lesions. A multidisciplinary approach and thorough diagnostic workup are crucial. Further research is needed to better understand the potential malignancy risk associated with breast sarcoidosis.