Chemotherapy-induced irreversible alopecia in early breast cancer patients

Breast Cancer Res Treat. 2017 Jun;163(3):527-533. doi: 10.1007/s10549-017-4204-x. Epub 2017 Mar 21.

Abstract

Purpose: The purpose of this work is to determine the prevalence of chemotherapy-induced irreversible alopecia (CIIA), which is defined as an alopecia that exists at least 6 months after completion of chemotherapy and factors affecting CIIA in early breast cancer patients.

Methods: We performed a cross-sectional study. We retrospectively identified breast cancer patients who had received AC (Adriamycin, Cyclophosphamide) or AC-T (AC followed by Taxane) as neoadjuvant or adjuvant chemotherapy. We conducted questionnaire survey regarding alopecia and measured hair density using phototrichogram.

Results: From February 2015 to May 2015, among 265 patients who responded properly to the questionnaire, the women who answered they had severe alopecia (alopecia > 50% of scalp) were 19 patients (7.2%). AC-only and AC-T treated patients reported severe alopecia in 2.7% and 10.5%, respectively, which were significantly different (p < 0.001). Mean hair density was 75 hair/cm2 (range 42-112) and 75.2/cm2 (range 48.3-102) on occipital area and vertex area, respectively. Hair loss was the most frequent in parietal area (42.6%). Half of total patients (46%) and 73% of CIIA patients regarded that their hair became thinner after chemotherapy CONCLUSIONS: We found that significant proportion of early breast cancer patients were suffering from severe CIIA, especially when they had been treated with AC followed by taxane regimen.

Keywords: Adverse reactions; Alopecia; Antineoplastic agents; Breast neoplasms; Drug-related side effects.

MeSH terms

  • Alopecia / chemically induced
  • Alopecia / epidemiology
  • Alopecia / pathology*
  • Breast Neoplasms / complications*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Bridged-Ring Compounds / administration & dosage
  • Bridged-Ring Compounds / adverse effects
  • Chemotherapy, Adjuvant / adverse effects*
  • Cross-Sectional Studies
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Drug-Related Side Effects and Adverse Reactions / pathology*
  • Female
  • Humans
  • Neoplasm Staging
  • Taxoids / administration & dosage
  • Taxoids / adverse effects

Substances

  • Bridged-Ring Compounds
  • Taxoids
  • taxane
  • Doxorubicin
  • Cyclophosphamide