Breast Cancer Radiation BOOP- Epler Pneumonia Alert

October 22 2012 – Gary Epler

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.

"BOOP: You’re the Boss" in paperback and eBook


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  • Dr. Gary Epler: February 23, 2017
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    BOOP may occur in some women who have had radiation therapy for breast cancer. The BOOP may occur in the same location as the radiation treatment, but often occurs in the opposite lung. There are usually minimal symptoms.

    Fortunately, if this is radiation BOOP, treatment is usually effective over time. The smallest effective dose for the least amount of time is usually given.

    Ask you lung specialist questions about the diagnosis and the treatment plan until you understand the answers. This will help you manage the situation as well as possible.

    I wish you good health and best wishes for success with your pulmonary condition.

    Gary R. Epler, M.D.

  • Susan Hill: February 23, 2017
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    Hi, i had breast cancer and radiation in jan. 2014. I developed boop and am now in my 4 th attempt to get off prednisone. The first 3 tries, when the does got to a certain number (?) the boop came back. They now have me down sizing .5 a month. Bummer.

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