Lower E E, Hawkins H H, Baughman R P
University of Cincinnati Medical Center, Department of Medicine, Ohio 45267-0562, USA.
Sarcoidosis Vasc Diffuse Lung Dis. 2001 Oct;18(3):301-6.
Breast disease in sarcoidosis can be classified as sarcoidosis patients with breast granulomas, sarcoidosis patients with breast cancer, and breast cancer patients displaying sarcoidosis-like breast reactions.
We reviewed the medical records of 629 women with sarcoidosis followed in the Interstitial Lung Disease Clinic at the University of Cincinnati for findings associated with breast disease. In addition, three women with breast cancer who had granulomas in proximity to their tumors were also examined.
Abnormal breast examinations or mammograms were reported in 15 patients with sarcoidosis (2% of women with sarcoidosis). Breast biopsy revealed granulomas consistent with sarcoidosis in six. One of them developed breast cancer five years later. Breast cancer was identified in twelve further patients, therefore a total of thirteen patients with breast cancer were identified. Ten were diagnosed with breast cancer plus sarcoidosis: sarcoidosis preceded breast cancer in three, followed breast cancer in five, the two diseases appeared simultaneously in two. Three additional women with breast cancer were also evaluated and classified as patients with sarcoid-like reaction. Review of the mammographic and physical findings could not distinguish between sarcoidosis in the breast and breast cancer.
Sarcoidosis patients develop breast cancer at the expected frequency. The breast cancer diagnosis may precede or follow that of sarcoidosis. There is no relationship between stage of sarcoidosis or treatment and the development of cancer. Because physical examination and mammography findings are unable to distinguish between sarcoidosis and malignancy, biopsy of all suspicious lesions in sarcoidosis is recommended.
结节病中的乳腺疾病可分为患有乳腺肉芽肿的结节病患者、患有乳腺癌的结节病患者以及表现出结节病样乳腺反应的乳腺癌患者。
我们回顾了在辛辛那提大学间质性肺病诊所随访的629例结节病女性患者的病历，以查找与乳腺疾病相关的发现。此外，还检查了3例肿瘤附近有肉芽肿的乳腺癌女性患者。
15例结节病患者（占结节病女性患者的2%）报告有乳腺检查异常或乳房X光检查异常。乳腺活检显示6例符合结节病的肉芽肿。其中1例在5年后患乳腺癌。另有12例患者被确诊为乳腺癌，因此共确诊13例乳腺癌患者。10例被诊断为乳腺癌合并结节病：3例结节病先于乳腺癌，5例结节病后于乳腺癌，2例两种疾病同时出现。另外3例乳腺癌女性患者也接受了评估，并被归类为有结节病样反应的患者。对乳房X光检查和体格检查结果的回顾无法区分乳腺结节病和乳腺癌。
结节病患者患乳腺癌的频率与预期相符。乳腺癌的诊断可能先于或后于结节病。结节病的分期或治疗与癌症的发生之间没有关系。由于体格检查和乳房X光检查结果无法区分结节病和恶性肿瘤，建议对结节病中所有可疑病变进行活检。
