A retrospective cohort study of women with breast cancer presenting to hair loss clinic.

reast cancer is the most common malignancy among women in the United States (American Cancer Society in Key Statistics for Breast Cancer. American Cancer Society, Atlanta, GA). Hair loss is common among women undergoing breast cancer treatment, however limited research has systematically characterized treatment-specific patterns of hair loss. The current study evaluates the distribution of alopecia, associated symptoms, and prevalence of hair loss risk factors among women undergoing breast cancer treatment. A retrospective chart review was conducted on 75 female breast cancer patients who presented for hair loss to the Dermatology Department at The Ohio State University. Patients were categorized based on chemotherapy history. Dependent variables included hair loss distribution, scalp symptoms, eyebrow or eyelash involvement, and nail findings. Among our cohort, hair loss most frequently involved the frontal scalp (52%), vertex (42.7%) and temporal scalp (26.7%). Diffuse alopecia was seen in 25.3% of patients. Eyebrow/eyelash loss was observed in 40% of patients, scalp symptoms in 28%, and nail changes in 21.3% of patients. Itching and flaking were the most common scalp symptoms, whereas onycholysis, fragility, and Beau's lines were the most common nail changes. Results revealed that chemotherapy exposure led to significantly higher eyebrow/eyelash loss and a trend towards an increase of diffuse alopecia. Non-chemotherapy-based treatments, 98% of which were endocrine therapy-based, were characterized by more localized hair loss primarily involving the frontal and temporal scalp, suggesting these distributions may be specific to endocrine therapy-related alopecia. Understanding the adverse effects related to specific therapeutic agents enables clinicians to provide personalized care and mitigate the psychological burden associated with breast cancer therapies.