Scalp cooling successfully prevents alopecia in breast cancer patients undergoing anthracycline/taxane-based chemotherapy

Breast. 2018 Aug;40:1-3. doi: 10.1016/j.breast.2018.04.012. Epub 2018 Apr 13.


Introduction: Chemotherapy for breast cancer induces alopecia, representing a major source of patient distress. This study assesses whether a scalp-cooling device is effective in reducing chemotherapy-induced alopecia, and assesses adverse treatment effects.

Materials and methods: A prospective observational study including women with breast cancer undergoing chemotherapy and scalp cooling using a Paxman device. The primary efficacy end points were: successful hair preservation (no hair loss; <30% hair loss not requiring a wig; or <50% hair loss not requiring a wig) at the completion of chemotherapy. Secondary end points included adverse effects such as headache, pain, nausea or dizziness.

Results: The study enrolled 131 participants. Mean patient age was 49.8 years; 74% received anthracycline/taxane-based chemotherapy and 26% received taxane-monotherapy based chemotherapy. Hair preservation was successful in 102 women who underwent scalp cooling (71.0%; 95% CI = 63-79%). Only adverse events related to device use were collected, representing 7% (95% CI = 3-11%) of cases.

Conclusions: Scalp cooling is effective in preventing hair loss among breast cancer patients undergoing standard chemotherapy treatment, and has minimal adverse effects.

Keywords: Alopecia; Breast cancer; Chemotherapy; Scalp cooling.

Publication types

  • Observational Study

MeSH terms

  • Alopecia / chemically induced
  • Alopecia / prevention & control*
  • Anthracyclines / adverse effects*
  • Antibiotics, Antineoplastic / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Bridged-Ring Compounds / adverse effects*
  • Cryotherapy / methods*
  • Female
  • Humans
  • Middle Aged
  • Prospective Studies
  • Scalp*
  • Taxoids / adverse effects*
  • Treatment Outcome


  • Anthracyclines
  • Antibiotics, Antineoplastic
  • Bridged-Ring Compounds
  • Taxoids
  • taxane