Abstract
A 55-year-old woman became aware of a 6-cm mass in her left breast accompanied by skin edema and pleuroparietopexy and therefore visited our hospital. We diagnosed the mass as an infiltrating ductal carcinoma (triple negative) with metastasis to the axilla and parasternal lymph nodes (T4cN3bM0 Stage IIIc). As treatment, the patient received FEC 100×5 and docetaxel hydrate ×4 followed by left total mastectomy and axillary lymph node dissection. Histopathologically, the tumor measured 24 mm in diameter (pN0). Because prior to the onset of chemotherapy, we observed enlarged parasternal lymph nodes, we administered postoperative radiation therapy (50 Gy) to the thoracic wall and supraclavicular fossa. Six months after the radiation, the patient developed fever and dyspnea. A chest radiograph revealed infiltrative shadows in the left lung, and a chest computed tomography image showed multiple infiltrative shadows and ground glass-like shadowy images. On the basis of these findings, we diagnosed the patient with organized pneumonia after radiation therapy. We initiated steroid therapy, but additionally administered cyclosporine owing to three episodes of recurrence upon reducing the steroid dose. Thus, we encountered a case of organized pneumonia after breast cancer operation and radiation therapy, wherein it was necessary to administer an immunosuppressive agent, and report our findings herein.
