Abstract Background: Chemotherapy-induced alopecia (CIA) is one of the most distressing side effects of systemic treatment in early-stage breast cancer (ESBC), negatively impacting quality of life (QoL) and sometimes leading patients to reject curative regimens. DigniCap® is an FDA-approved scalp cooling system recommended by NCCN and ESMO guidelines. However, regional evidence for Latin America is scarce, and differences in hair type, access, and health system structure may affect outcomes. This study examines the real-world efficacy and tolerability of DigniCap in Uruguayan patients, comparing results between the public university hospital (Hospital de Clínicas) and private clinics. Methods: A prospective single-arm cohort included Uruguayan women with ESBC receiving adjuvant or neoadjuvant anthracycline/taxane-based chemotherapy (March 2022-June 2025). Hair loss was evaluated using Dean’s scale (success: Dean 0-2). The primary analysis focused on CIA prevention rates and device discontinuation by care setting. Results: Among 122 patients, overall success was 83.6% (≤50% hair loss). Device discontinuation due to chemotherapy toxicity or DigniCap intolerance occurred in 17%. By care setting: Public (HC, n=49): Success 75%; discontinuation 24.5%. Private patients (n=73): Success 84.9%; discontinuation 4,1%. The highest success rates were seen with the TCHP (85,7%) and TC (85.4%) regimens. Reported adverse events included headaches, scalp discomfort, and cold intolerance, which were mostly mild. 83.1% of participants completed all planned cycles with DigniCap. Conclusions: This first Uruguayan cohort demonstrates that DigniCap is effective and well-tolerated for CIA prevention, achieving outcomes comparable to those of international trials. The success gap and higher discontinuation rate among public hospital patients underscore the need to address logistical barriers, provide hair care counseling, and offer supportive resources to ensure equitable benefits across all settings. Regional real-world data support the advocacy for broader insurance coverage and tailored protocols to enhance patient acceptance and treatment adherence. Local evidence on DigniCap® strengthens the case for implementing scalp cooling programs in Latin America, considering specific hair characteristics, health system inequities, and patient-centered QoL goals. Citation Format: D. Amarillo, J. Manzanares, B. Insagaray, M. García, N. Camejo, C. Castillo, G. Krygier. Digni-t-uy: efficacy of dignicap® scalp cooling in uruguayan breast cancer patients - a public vs. private care comparison abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-03-12.
Amarillo et al. (Tue,) studied this question.