[A Case of Drug-Induced Interstitial Lung Disease Associated with Epirubicin and Cyclophosphamide Therapy before Operation]

Gan To Kagaku Ryoho. 2019 Jan;46(1):160-162.
[Article in Japanese]

Abstract

We report the case of a 60-year-old woman with right breast cancer. Approximately 18 years had passed since the treatment for left breast cancer without recurrence. She became aware of the right breast tumor with mild pain 5 months before she came to the hospital. The diagnosis was right-sided breast cancer, cT2N0M0, StageⅡA, ER(-), PgR(-), HER2(-). Neoadjuvant chemotherapy was chosen, and then combined treatment with epirubicin(EPI)and cyclophosphamide(CPA) was started. The breast tumor had become smaller, but she complained of shortness of breath during the third course of chemotherapy. On the basis of her history of cancer onset, chest CT findings, and increase in serum SP-D levels, the combined therapy with EPI and CPA was suspected as the cause of the drug-induced interstitial lung disease(DILD). For this reason, the therapy was discontinued. After her recovery from this state, the operation(partial mastectomy and sentinel lymph node biopsy)was performed. S-1 was used as postoperative adjuvant therapy, and the respiratory symptoms did not recur or worsen. On the basis of the disease course, we made a diagnosis of DILD with EPI and CPA. Many anticancer drugs may cause DILD. In case of a suspicion of DILD onset, a prompt diagnosis and an appropriate treatment are important.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Breast Neoplasms* / diet therapy
  • Cyclophosphamide / adverse effects
  • Epirubicin / adverse effects
  • Female
  • Humans
  • Lung Diseases, Interstitial* / chemically induced
  • Mastectomy
  • Middle Aged
  • Neoplasm Recurrence, Local

Substances

  • Epirubicin
  • Cyclophosphamide