Bronchiectasis Program

Multidisciplinary Care Team

The Massachusetts General Hospital Bronchiectasis Program brings together a multidisciplinary team of pulmonologists, chest radiologists, infectious disease experts, physical therapists, specialized nursing and research-scientists. Our clinicians have decades of experience treating bronchiectasis and work to:

• Deliver comprehensive care for patients with bronchiectasis, which is chronic scarring of the airways (breathing passages) that lead to the lungs
• Provide care for chronic infections that are related to bronchiectasis, including non-tuberculous mycobacteria (NTM), Pseudomonas aeruginosa, aspergillosis and other disorders
• Educate patients and their families about these uncommon ailments
• Educate other clinicians about diagnosis and treatment
• Provide access to nationwide research consortia and clinical trials

What to Expect

Our program is headquartered on the second floor of the Cox Building on Mass General’s Boston campus. Before your first visit, please have any past evaluations or test results—including sputum culture results and prior imaging studies, such as computed tomography (CT) scans—loaded on a CD for our review; copies of the reports on paper are not sufficient.

At your first visit, you will meet with the pulmonologist who will direct your care. You can expect:

• An in-depth discussion about your past medical history, the course of your illness and any questions you have
• A complete physical examination
• A thorough review of prior diagnostic studies (CT scans, chest X-Rays, blood work, etc.)
• Referral to physical therapy, infectious disease, thoracic imaging and thoracic surgery specialists, as appropriate
• A multidisciplinary plan developed by your care team in the Bronchiectasis Program to diagnose and manage your medical problems and arrange follow-up appointments, as needed

State-of-the-Art Testing

Bronchiectasis can occur as the result of a genetic disorder, immune deficiency, previous lung infection or autoimmune disease. In up to half of cases, the cause is unknown or idiopathic. Determining the exact type and cause of your lung disease is important for formulating the most tailored treatment plan possible.

Our program offers access to a variety of testing to best inform your disease management, including:

• Pulmonary function testing, or investigations of how well your lungs work, in our nationally recognized physiology lab
• Blood chemistry tests and genetic testing
• High-resolution CT scan of the chest
• Bronchoscopy, a procedure that involves the passage of a small, flexible fiber optic camera through the mouth into the lungs to obtain fluid and tissue to aid in diagnosis of possible infections in the lungs

An Individualized Treatment Plan

The mainstay of bronchiectasis management is to enhance airway clearance through cough assistance which enables us to eliminate the mucous from your breathing passages. This helps to reduce symptoms and decrease the amount of time feeling sick. The chronic lung infections require specialized management that varies based on the patient and the pathogen (bacteria, virus, fungus) and may involve collaborating with other specialized services to provide the best care:

• Physical Therapy: Our physical therapists specialize in chest physiotherapy and cough assistance, both of which are the foundation of bronchiectasis management
• Interventional Pulmonology: Our interventional pulmonary unit features state-of-the-art diagnostic and therapeutic procedures
• Thoracic, or Chest Imaging: Our radiologists are national and international leaders in the field of advanced lung and chest imaging and interventional procedures
• Infectious Disease: Our world-renowned infectious disease division has many physicians who are experts in the management of the chronic infections that can occur in bronchiectasis
• Thoracic Surgery: Our chest surgeons have more than a century of national and international leadership in complex surgery of the chest and lung disorders, including bronchiectasis

Challenging cases are presented at our monthly interdisciplinary conference involving pulmonologists, infectious disease experts, chest radiologists and chest surgeons.

Our program offers diagnosis and treatment of the full spectrum of possible bronchiectasis complications including:

• Idiopathic bronchiectasis
• Cystic Fibrosis Transmembrane Regulator (CFTR) Dysfunction Syndromes
• Primary Ciliary Dyskinesia
• Allergic Bronchopulmonary Aspergillosis
• Non-tuberculous mycobacterial infection, which is treated in collaboration with the Mass General Mycobacterial Center
  • Mycobacterium avium complex (MAC)
  • abscessus
  • kansasii
• Cystic Fibrosis, which is diagnosed and managed at the Mass General Cystic Fibrosis Center

Research, Clinical Trials and Patient Support

Mass General has long been one of the leading research hospitals in America. The Bronchiectasis Program:

• Is a participating site in the COPD Foundation’s National Bronchiectasis and NTM Research Consortium
• Provides access to national clinical trials for new bronchiectasis treatments

Training the Next Generation of Pulmonologists

As part of a world-class academic medical center, the Division of Pulmonary and Critical Care Medicine is continually preparing the next generation of leaders in academic pulmonary and critical care medicine. Physicians in our fellowship program receive clinical and research training in bronchiectasis and all other major lung conditions.

Alice DuBois, NP

Tzippora Vogel, PA