Interstitial pneumonia associated with neoadjuvant chemotherapy in breast cancer

Interstitial pneumonia (IP) is a critical adverse event that may occur during anticancer chemotherapy. Physicians should be aware of the possibility of IP, particularly when dealing with patients on neoadjuvant chemotherapy (NAC) since delays in diagnosis and treatment interfere with the scheduled operation. In our institution, fluorouracil, epirubicin and cyclophosphamide (FEC) followed by weekly paclitaxel is the standard NAC regimen for operable breast cancer cases. In the present study, 95 patients with breast cancer were treated with this regimen, 5 of whom (5.3%) developed IP during NAC. All 5 cases were diagnosed when anticancer therapy was withdrawn and steroid pulse therapy was initiated. Consequently, the standard operation was immediately performed. In conclusion, physicians should be aware that IP may occur at any point during NAC and that it should be immediately diagnosed and treated to avoid delay of the therapeutic plan.