Hair preservation during chemotherapy in early breast cancer:
experience at a university center in Uruguay
Abstract
Background: Chemotherapy-induced alopecia (CIA) is one of the most frequent adverse effects in breast cancer patients and has a significant psychosocial impact. Scalp cooling has emerged as an effective strategy for its prevention, although evidence from Latin America remains limited.
Objective: To evaluate the effectiveness of scalp cooling in preventing chemotherapy-induced alopecia in Uruguayan patients with early-stage breast cancer, as well as its safety, tolerability, and impact on quality of life.
Materials and Methods: A prospective, observational, single-arm study was conducted, at the Hospital de Clínicas, School of Medicine, Universidad de la República, Uruguay, including patients aged ≥18 years with early-stage breast cancer receiving adjuvant or neoadjuvant chemotherapy. Scalp cooling was applied using the DigniCap™ automated system (Dignitana AB, Lund, Sweden) during chemotherapy administration. Effectiveness was defined as ≤50% hair loss according to the Dean scale, assessed through standardized photographic records and independent evaluation. Adverse events, treatment tolerability, and quality of life (EORTC QLQ-BR23) were also analyzed.
Results: A total of 40 patients were included. The overall hair preservation rate was 67.5% (95% CI: 52.0–79.9%). Higher success rates were observed in patients treated without anthracyclines compared to those receiving anthracycline-based regimens (95% vs. 45%; 95% CI: 76.4–99.1% vs. 25.8–65.8%; p=0.001). The procedure was well tolerated, with frequent but mild adverse events, mainly headache and cold-related discomfort. Overall quality of life was preserved, with a favorable perception of body image in most patients.
Conclusions: Scalp cooling is an effective and safe strategy to reduce chemotherapy-induced alopecia in early breast cancer patients, with a positive impact on the treatment experience. These findings provide local evidence supporting its incorporation as a supportive care strategy in clinical practice
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