Sarcoidosis is an idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. Breast involvement is extremely rare, but, when present, it could be confused with a benign or, more important, a malignant neoplasm. We have reported a case of sarcoidosis of the breast in a 51 years old woman with systemic manifestations of sarcoidosis (arthralgias and uveitis) associated with a breast mass and with a clinical history of fibrocystic mastopathy. A chest X-ray and a Computed Tomography (CT), with raised serum levels of Angiotensin Converting Enzyme (ACE), were compatible with a diagnosis of sarcoidosis. The mammography and ultrasonogram showed a solitary little nodular lesion localized in the breast. A breast cancer in a patient with sarcoidosis? To answer this question, the patient performed breast surgery under general anaesthesia and bioptic microscopic examination showed a typical sarcoid granuloma.