Breast Cancer Radiation BOOP- Epler Pneumonia Alert

Gary R. Epler, M.D.

Breast Cancer Awareness: A strange lung disease called BOOP [bronchiolitis obliterans organizing pneumonia] may develop in some women who have had radiation treatment for breast cancer. It may be a funny sounding name, but I discovered this disease several years ago, and it can be serious or even lethal if not diagnosed and treated with the right medicine. 

BOOP is inflammation of the lungs. The BO in BOOP is “bronchiolitis obliterans” which means the small bronchiole airways are filled with inflammation. The OP in BOOP is “organizing pneumonia” which means the lungs are filled with inflammation. BOOP is often called Epler’s pneumonia.

In most situations, the cause is unknown, but sometimes BOOP occurs among women who have had radiation treatment for breast cancer. This type of BOOP usually occurs from three months to six months after the radiation treatment is completed. There may be no symptoms, but cough, fever, and shortness of breath are common. The lung examination is usually normal. The chest x-ray or computer scan shows hazy shadows, and surprisingly, usually in the lower lungs away from the radiation field. This type of BOOP is almost always curable with the powerful anti-inflammatory corticosteroid medication, or “steroids.” Fortunately, in some women, this type of BOOP can be closely monitored without medication and resolves over time. In conclusion, if pneumonia occurs during the first year after radiation treatment, it could be BOOP.

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