Background

A small number of patients who receive docetaxel-containing regimes for early breast cancer (EBC), experience permanent alopecia. The aim of this study was to determine the incidence, the site, the extent, and duration of the hair loss.

Method

A postal questionnaire was sent (in October 2013) to patients who had received docetaxel during 2010, in the neo/adjuvant settings for EBC at our  cancer centre. This comprised questions relating to scalp hair loss, hair loss to other parts of the body, hair products used, and any comments that the respondents wished to add about their experience of hair loss. Univariate and multivariate analyses were undertaken to determine any other risk factors for persistent alopecia.

Results

134 of 189 questionnaires were returned. Of those responding 21 (15.8%) had significant persistent scalp hair loss.  16 patients in the study were using products such as wigs and hair extensions. 5 patients reported no regrowth of eyebrows, 2 patients reported no eyelash regrowth, 6 no regrowth of nostril hair and 14 no regrowth to other parts such as legs. Univariate and multivariate analyses showed no significant associations with other patient and treatment characteristics (eg adjuvant endocrine therapy, menopausal status). Patients' observations confirmed a significant impact on quality of life.

Conclusion

Long term significant scalp alopecia (here lasting for up to 3.5 years following completion of chemotherapy) may affect 10-15% of patients following docetaxel for EBC. This appears to be unrelated to other patient and treatment characteristics. Long term hair loss has a significant impact on quality of survival. Further prospective study is required to confirm incidence and to identify effective preventive and management strategies. This risk should be discussed routinely (as part of the process of informed consent) with all patients embarking upon docetaxel as a component of management of EBC.