Abstract P5-15-09: National survey of chemotherapy-induced appearance issues in breast cancer patients
Authors: Watanabe Takanori , Yagata Hiroshi , Saito Mitsue , Okada Hiroko , Takayama Tomoko , Imai Hirohisa , Yoshida Yuko , Tamai Nao , Nozawa Keiko , Yajima Tamiko , Shimozuma Kojiro 
Published: May 2015

Background: Many breast cancer patients suffer hair loss due to chemotherapy, and not only scalp hair loss, but also eyebrow loss, eyelash loss and nail changes induced by chemotherapy are traumatic for patients. These side effects diminish self-esteem and greatly reduce quality of life. However, there has been little research in this field until now. To clarify the actual situation concerning appearance issues in breast cancer patients who received adjuvant chemotherapy, and to consider a support system for these patients, we conducted a questionnaire survey.

Methods: Disease-free breast cancer patients who have received adjuvant chemotherapy containing anthracycline and/or taxane within 5 years were recruited from 47 hospitals or clinics in Japan from April to October 2013. The patients participating in this survey completed a 65-question questionnaire concerning appearance issues (48) and their perception of physical and non-physical side effects (17). The drugs administered and treatment period were filled out by their doctors beforehand. The completed questionnaires were mailed directly to the data center by the patients.

Results: A total of 1511 patients returned the questionnaire to the data center with a response rate of 82% (1511/1853). Since 33 patients did not meet the entry criteria, the questionnaires returned by 1478 patients were analyzed in this survey. The mean age was 54.7 years (+-10.4, range 17-79). The distribution of the patients by time from the end of chemotherapy to this survey was as follows: &lt; 1 year: 28%; 1 to 2 years: 24%; 2 to 3 years: 19%; 3 to 4 years: 15%; 4 to 5 years: 13%. In this survey, the side effect that most patients (92%) considered traumatic was hair loss. The second most traumatic side effect was fatigue (83%), while the 7th place was taken by nail changes (72%) and nausea/vomiting was in the 10th place (56%). During chemotherapy, scalp hair loss occurred in 98% of patients. Eyebrows fell out in 90% and complete eyebrow loss occurred in 36%. Eyelashes fell out in 88% and complete eyelash loss occurred in 37%. Fingernail changes occurred in 77% and toenail changes in 62%. In 60-70%, scalp hair, eyebrow and eyelashes recovered to the original appearance by 1 to 1.5 years after chemotherapy, but in 3-7%, scalp and face hair loss did not recover at all by 1 to 1.5 years. This proportion remained almost the same for 1.5 to 5 years too. During or after chemotherapy, 84% of patients used wigs. This decreased to 47% by 1 year after chemotherapy and 15.2% by 1.5 years. However 10% of patients were still using a wig 4 to 5 years after chemotherapy. Approximately 30% of the patients had trouble using and selecting a wig. In 51% of the patients, sufficient information on scalp hair loss was obtained. However, sufficient information on eyebrow loss, eyelash loss and nail changes was only obtained from 28%, 25% and 31%, respectively.

Conclusions: Our survey demonstrated the outline of hair loss and appearance issues in breast cancer patients who received chemotherapy. Hair loss is the most distressing and occasionally long-lasting side effect. Lack of information is a serious problem. These facts suggested a need for long-time and careful support of these patients.

Citation Format: Takanori Watanabe, Hiroshi Yagata, Mitsue Saito, Hiroko Okada, Tomoko Takayama, Hirohisa Imai, Yuko Yoshida, Nao Tamai, Keiko Nozawa, Tamiko Yajima, Kojiro Shimozuma. National survey of chemotherapy-induced appearance issues in breast cancer patients [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-15-09.