Pneumotox » Drug » Radiation therapy to the breast

Radiation therapy to the breast

Main risk to the lung is organizing pneumonia. Risk to the heart greater with irradiation of left-sided breast tumors. See also under other radiation deliveries and patterns

Last update : 23/08/2018

I.b Pneumonitis (ILD)

I.c Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

I.d Organizing pneumonia pattern (an area or areas of consolidation on imaging)

I.h Subclinical pulmonary infiltrates/ILD

I.o Focal/localized area of pneumonitis/fibrosis

I.u Relapsing or migrating pneumonitis/pneumonia (see also Id)

I.v Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence

I.z An area or areas of consolidation

V.t The apical cap

XII.b Valvular heart disease and/or dysfunction

XII.c Pericardial effusion (w/wo tamponade)

XII.o Coronary artery disease (subacute, chronic)

XIII.a Lung cancer

XIII.m Tumor of the heart

XV.c Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)

XVI.i Imaging: An area or areas of involvement with a recognizable anatomic distribution

XIX.a BAL: An excess proportion of lymphocytes

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

More detailed checklist

The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France