A case of bronchiolitis obliterans organizing pneumonia after conservative treatment of breast cancer

Abstract

The patient was a 42–year–old female performed conservative surgery for left breast cancer, followed by postoperative radiation therapy at a total dose of 56 Gy. About two months after completion of irradiation, cough and fever developed. Lung infiltrates were initially localized in the irradiated area, but later spread to unirradiated areas in both lungs. We clinically diagnosed this case as radiation–induced bronchiolitis obliterans organizing pneumonia (BOOP) by TBLB findings. After initiation of prednisolone regimen the clinical symptoms and infiltrates seen in the radiograph disappeared. In the course of tapering the prednisolone dose, new infiltrative shadows developed in the unirradiated areas in both lungs. The increased dose of predonisolone resulted in a rapid improvement of the clinical symptoms and chest radiograph abnormalities. Following several bouts of recurrences of BOOP which had been successfully managed by prednisolone regimen, the patient has been free from recurrence, as of one year after withdrawal of prednisolone.
It is important to be aware of this type of pulmonary complication in patients given breast radiation after conserving surgery for breast cancer.