Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients

Publication date: Available online 8 March 2017
Source:Journal of the American Academy of Dermatology
Author(s): Athina Fonia, Carlo Cota, Jane F. Setterfield, Lynne J. Goldberg, David A. Fenton, Catherine M. Stefanato
BackgroundAnagen effluvium with reversible scalp alopecia is a known side effect of chemotherapy. However, there are an increasing number of reports in the literature documenting permanent alopecia in patients treated with taxanes.ObjectiveWe sought to describe the clinicopathologic features in breast cancer patients who underwent treatment with taxanes and adjuvant hormonal chemotherapy.MethodsWe reviewed the clinical and histopathologic information of a cohort of 10 patients treated with taxanes and adjuvant hormonal chemotherapy.ResultsWe have observed 3 types of clinical patterns of alopecia (types A, B, and C), and have validated the histopathologic features showing alopecia areata–like and female pattern hair loss.LimitationsThe study was based on a small sample size and retrospective retrieval of clinical information and histopathologic review of posttreatment slides.ConclusionsWe hypothesize a clinicopathologic model of hair follicle cycle disruption in response to the chemoinflammatory and hormonal insults to the hair follicles resulting in permanent alopecia. Clinicopathologic correlation is paramount to the understanding of the morphobiologic pathways in chemotherapy-induced alopecia caused by taxanes and adjuvant hormonal treatment.



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