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Abstract Purpose Chemotherapy-induced alopecia (CIA) negatively impacts quality of life of breast cancer patients. The present observational study was designed to confirm the efficacy and safety of scalp-cooling system to prevent CIA in early breast cancer (BC) patients undergoing (neo)adjuvant chemotherapy. Methods We prospectively evaluated all early BC patients undergoing scalp cooling during (neo)adjuvant chemotherapy in our Institution. Primary endpoint was to assess the success of scalp cooling system (hair loss ≤ 50%). Results We included 252 early breast cancer patients treated from May 2016 to July 2023; median age was 49 years, 46% had stage II disease. Most of them received adjuvant chemotherapy (77.4%) and anthracycline-based regimens (78.2%). Hair loss ≤ 50% was observed in 72% of overall patients: in all patients treated with paclitaxel weekly-based chemotherapy, and in 63% and 75% of pts treated with anthracycline and docetaxel-cyclophosphamide regimens respectively (anthracycline-based versus anthracycline-free regimens, p ≤ 0.05). Hair thickness, straightening, permanent hair and BMI were factors linked to the risk of hair loss (p ≤ 0.05). Sixty-nine percent of patients had almost one adverse event, coldness the most frequent (62%); 13% of patients early discontinued the use of the scalp cooling system. With a median months of follow-up of 35 months, no scalp metastasis was reported. Conclusion These results support the use of scalp-cooling in preventing CIA for early breast cancer patients receiving (neo)adjuvant chemotherapy especially if they underwent anthracycline-free regimens, reducing the negative psychological impact of oncological treatments on their lives.
Pasqualoni et al. (Tue,) studied this question.