Clinicopathologic Characteristics and Response to Treatment of Persistent Chemotherapy-Induced Alopecia in Breast Cancer Survivors
- Study type
- Other
- Design
- Retrospective case series in 4 specialist hair clinics, from 1 November 2011 to 29 February 2020
- Sample size
- 100 patients
- Source
- JAMA Dermatol · 2021
In plain words
In some breast cancer survivors, hair loss after chemotherapy (especially with drugs of the taxane group) does not recover and lasts for months or years. In this study, the pattern of this hair loss in most patients looked like inherited (androgenetic) hair loss. With minoxidil applied to the scalp or taken by mouth, sometimes together with anti-androgen medicines, hair density improved in many patients. If hair loss continues after chemotherapy has finished, talk to your doctor or a hair and skin specialist, and do not start any medicines without medical advice.
Key results
Treatment arms and regimens
Topical and oral minoxidil, sometimes with anti-androgen therapy. Dose details in the full text of the paper.
Source of the regimen details: Abstract of the paper; dose details in the full text of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Patients with persistent chemotherapy-induced alopecia (pCIA) after chemotherapy for breast cancer seen at 4 specialist hair clinics. Of the 100 patients, 99 (99%) were women. Mean age at presentation was 54.0 years (range 29.0 to 74.1 years).
Endpoints
Main outcomes: clinical, trichoscopic and histopathological features and treatment results. In patients presenting with diffuse hair loss or diffuse thinning of the mid-frontal scalp with widening of the central part and preserved frontal hairline, severity was graded on the Sinclair scale (grade 1 to 5). Grade 1 indicates normal hair density and grade 5 the most severe hair loss, with little or no hair in the centroparietal area.
Safety and side effects
The abstract reports no data on treatment adverse events.
Clinical significance and place in guidelines
This study is descriptive and has no control group, so it cannot definitively prove the effect of the treatments. Nevertheless, it shows physicians that pCIA after breast cancer chemotherapy, especially after taxane-containing regimens, can resemble androgenetic alopecia and may improve in some patients with minoxidil (with or without anti-androgen therapy). The abstract does not mention the place of these treatments in clinical guidelines, which should be checked separately.
Limitations
The retrospective design without a control group, the setting of specialist hair clinics (possible selection bias) and the use of varied and sometimes combined treatments are limitations of the study. These are stated based on the study design and are not explicitly discussed in the abstract. Sinclair grading was used only for patients with a specific pattern of diffuse hair loss.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.