We report on a 56 years old women with an enlarging breast mass in the region of an old scar due to a former diagnostic excision. Mammography and sonography were without value while MRT was suspicious for breast cancer. In the frozen section of the excised tissue a carcinoma was diagnosed and therefore a mastectomy performed. This diagnosis was in correct, instead a granulomatous process in the breast and the axillary lymph nodes took place. In respect to a pulmonary sarcoidosis and to laboratory results a true breast sarcoidosis may be supposed. It was also discussed whether it could be a lipogranulomatous pseudosarcoidosis.