Abstract P5-15-17: National survey of long-term recovery from chemotherapy-induced hair loss in patients with breast cancer

Abstract

Abstract Background: Altered appearance due to chemotherapy is a very distressing adverse event and can remain unrecovered for a long time after chemotherapy. To clarify the current status of appearance change and its support systems, we conducted a national questionnaire survey of patients with breast cancer who had received chemotherapy in Japan. Here, we report on the long-term recovery of scalp hair loss during and after chemotherapy. Patients and methods: A questionnaire was distributed to patients in hospitals throughout Japan between April and October 2013. The questionnaire was regarding the current status of the patients’ appearance issues (scalp hair, eyebrows, eyelashes, nails, skin) related to chemotherapy and its support systems, including chemotherapy regimens received, endocrine therapy received, and duration after chemotherapy. Eligible patients were women with breast cancer without any recurrence who had received adjuvant or neoadjuvant chemotherapy containing anthracycline (A) and/or taxanes (paclitaxel, P; docetaxel, D) and who were within 5 years from the last chemotherapy treatment. The physicians of each hospital asked their patients to fill out the questionnaire and mail it directly to the data center. The scalp hair status was analyzed in a cross-sectional manner according to the duration from chemotherapy. Results: The questionnaires were returned from 1511 patients in 47 hospitals (response rate, 82%; 1511/1853). Thirty-three patients were excluded, mainly because >5 years had passed since chemotherapy. In total, 1478 questionnaires were ultimately analyzed. The median age was 50 (range, 17–79) years. The distribution of patients according to time from the last chemotherapy treatment was as follows: <1 year, 28%; 1–2 years, 24%; 2–3 years, 19%; 3–4 years, 15%; and 4–5 years, 13%. During chemotherapy, scalp hair loss occurred in 98.4% of the patients, and 94% experienced >80% hair loss. Hair growth began during chemotherapy in 13.1% of patients and after chemotherapy in 80.3% (6.6% left the question unanswered). Within 6 months from the start of hair growth, 65% of patients felt a change in hair thickness, while 82% felt it was becoming thin. Of the patients, 70% felt a change in quality, while 48% felt that it had become unruly; 44% felt a color change, while 80% felt that they were growing more gray hair. Of the patients who answered the questions, >80% hair volume recovery was seen in 52.7% of patients within 1 year; in 63.5%, in 1–3 years; and in 61.7%, even after 3 years. After 3 years, volume recovery was seen in 67.8% of patients after an A+P–containing regimen; in 43.4%, after A+D; in 63.5%, after D; and in 88.9%, after A. Patients who had received A+P, D, and A+D had significantly less volume recovery than patients who had received A (P<0.001 for all). Conclusions: Almost all patients with breast cancer experienced severe hair loss during standard chemotherapy, but a recovery trend was noted after chemotherapy. However, hair remained unrecovered to various degrees in a significant number of patients even 3–5 years after chemotherapy, especially in those who had received taxane-containing regimens. We should consider the support needs of patients who experience chemotherapy-induced hair loss. Citation Format: Hiroshi Yagata, Takanori Watanabe, Hiroko Okada, Mitsue Saito, Tomoko Takayama, Hirohisa Imai, Yuko Yoshida, Nao Tamai, Keiko Nozawa, Tamiko Yajima, Kojiro Shimozuma. National survey of long-term recovery from chemotherapy-induced hair loss in patients with breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-15-17.