Post-breast cancer radiotherapy bronchiolitis obliterans organizing pneumonia

Abstract

Post-radiotherapy bronchiolitis obliterans organizing pneumonia may occur in as many as 2.3% of women receiving radiation therapy for breast cancer. Cough and fever are common symptoms, and a quarter of these women have no symptoms. Latency period is usually within 6 months after completion of therapy but may be as long as 1 year. Pulmonary function is normal or will show slight decreases in vital capacity and diffusing capacity. Chest computed tomography studies show ground-glass opacities with air bronchograms within and outside the radiation field, and there are often peripheral triangular-shaped infiltrates. Management consists of close monitoring of women who have no symptoms or minimal symptoms, and a short-course of corticosteroid therapy for women who have symptoms and extensive bronchiolitis obliterans organizing pneumonia. The prognosis is excellent; there have been no deaths reported.

Keywords::

• breast radiotherapy
• bronchiolitis obliterans organizing pneumonia
• bronchoalveolar lavage lymphocytosis
• radiation bronchiolitis obliterans organizing pneumonia
• reversed halo sign
• triangular-shaped ground-glass opacities

Financial & competing interests disclosure

GR Epler has served as an expert witness in plaintiff and defense cases. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.