Perceptions of delayed alopecia among breast cancer survivors

Abstract

BackgroundRetrospective studies suggest that some breast cancer survivors report treatment-associated hair loss or thinning years after their diagnosis. This study investigates frequency and perceptions of alopecia persisting 6 years after patients’ breast cancer diagnoses. MethodsBreast cancer survivors participating in the Mayo Clinic Breast Disease Registry (MCBDR) were mailed a survey 6 years after diagnosis. They were asked about their degree of bother from hair thinning and hair loss and mental health was explored. ResultsA total of 969 of 1476 participants (65.7%) responded to the survey. Of these, 755 patients were eligible for inclusion and had stage I-III breast cancer. Respondents' median age was 65.6 years (35-95 years). Chemotherapy (± endocrine therapy) was administered to 216 (29%) participants, and 342 (45%) received only endocrine therapy. Nearly half (345, 46%) of respondents reported hair loss and over half (431, 57%) reported hair thinning. Moderate to extreme bother from hair loss was reported by 27% of chemotherapy recipients, by 18% of endocrine therapy only recipients, and by 14% of patients who received neither. Moderate to extreme bother from hair thinning was reported by 31% of chemotherapy recipients, by 21% of endocrine therapy-only recipients, and by 19% of those who had received neither. Hair growth product usage was reported by 31% of chemotherapy recipients and 14% of endocrine therapy-only recipients. ConclusionsHair loss and thinning are frequently reported as persistently bothersome symptoms by breast cancer survivors. Future investigations into the incidence, predictors, and treatment of therapy-associated alopecia are needed.Micro Abstract: Chronic alopecia related to breast cancer treatment is a distressing symptom. In our cohort study of breast cancer survivors 6 years after diagnosis, 46% reported hair loss and 57% reported hair thinning. Moderate to extreme bother from hair loss and thinning was common, especially post-chemotherapy, and 19% of respondents used hair regrowth products. These findings emphasize the need for addressing persistent treatment-associated alopecia.