Skip to main content
Top
Published in: Breast Cancer Research and Treatment 2/2017

Open Access 01-06-2017 | Review

Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis

Authors: Hope S. Rugo, Susan A. Melin, Jeff Voigt

Published in: Breast Cancer Research and Treatment | Issue 2/2017

Login to get access

Abstract

Purpose

The risk of scalp metastases in patients using scalp cooling for preservation of hair during chemotherapy has been a concern but is poorly described.

Methods

A systematic review and meta-analysis of longitudinal studies was undertaken to evaluate the effect of scalp cooling versus no scalp cooling on the risk of scalp metastasis in patients treated for breast cancer with chemotherapy. Electronic databases, journal specific, and hand searches of articles identified were searched. Patients were matched based on disease, treatment, lack of metastatic disease, and sex.

Results

A total of 24 full-text articles were identified for review. Of these articles, ten quantified the incidence of scalp metastasis with scalp cooling over time. For scalp cooling, 1959 patients were evaluated over an estimated mean time frame of 43.1 months. For no scalp cooling, 1238 patients were evaluated over an estimated mean time frame of 87.4 months. The incidence rate of scalp metastasis in the scalp cooling group versus the no scalp cooling group was 0.61% (95% CI 0.32–1.1%) versus 0.41% (95% CI 0.13–0.94%); P = 0.43.

Conclusion

The incidence of scalp metastases was low regardless of scalp cooling. This analysis suggests that scalp cooling does not increase the incidence of scalp metastases.
Appendix
Available only for authorised users
Literature
4.
go back to reference Henry NL, Somerfield MR, Abramson VG et al (2016) Role of patient and disease factors in adjuvant systemic therapy decision making for early-stage, operable breast cancer: American society of clinical oncology endorsement of cancer care Ontario guideline recommendations. J Clin Oncol 34:2303–2311CrossRefPubMed Henry NL, Somerfield MR, Abramson VG et al (2016) Role of patient and disease factors in adjuvant systemic therapy decision making for early-stage, operable breast cancer: American society of clinical oncology endorsement of cancer care Ontario guideline recommendations. J Clin Oncol 34:2303–2311CrossRefPubMed
5.
go back to reference Choi EK, Kim I-R, Chang O et al (2014) Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psycho-Oncology 23:1103–1110CrossRefPubMed Choi EK, Kim I-R, Chang O et al (2014) Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psycho-Oncology 23:1103–1110CrossRefPubMed
6.
go back to reference Rosman S (2004) Cancer and stigma: experience of patients with chemotherapy-induced alopecia. Patient Educ Couns 52:333–339CrossRefPubMed Rosman S (2004) Cancer and stigma: experience of patients with chemotherapy-induced alopecia. Patient Educ Couns 52:333–339CrossRefPubMed
7.
go back to reference Lemieux J, Maunsell E, Provencher L (2008) Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: a literature review. Psycho-Oncology 17:317–328CrossRefPubMed Lemieux J, Maunsell E, Provencher L (2008) Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: a literature review. Psycho-Oncology 17:317–328CrossRefPubMed
8.
go back to reference Mols F, van den Hurk C, Vingerhoets AJJM et al (2009) Scalp cooling to prevent chemotherapy-induced hair loss: practical and clinical considerations. Support Care Cancer 17(2):181–189CrossRefPubMed Mols F, van den Hurk C, Vingerhoets AJJM et al (2009) Scalp cooling to prevent chemotherapy-induced hair loss: practical and clinical considerations. Support Care Cancer 17(2):181–189CrossRefPubMed
9.
go back to reference FDA Medical Devices (2016) General and plastic surgery devices; classification of the scalp cooling system to reduce the likelihood of chemotherapy-induced alopecia. Food and Drug Administration, HHS. Fed Regist 81(29):7452–7454 FDA Medical Devices (2016) General and plastic surgery devices; classification of the scalp cooling system to reduce the likelihood of chemotherapy-induced alopecia. Food and Drug Administration, HHS. Fed Regist 81(29):7452–7454
10.
go back to reference Grevelman EG, Breed WPM (2005) Prevention of chemotherapy-induced hair loss by scalp cooling. Ann Oncol 16:352–358CrossRefPubMed Grevelman EG, Breed WPM (2005) Prevention of chemotherapy-induced hair loss by scalp cooling. Ann Oncol 16:352–358CrossRefPubMed
11.
go back to reference Lemieux J, Amireault C, Provencher L, Maunsell E (2009) Incidence of scalp metastases in breast cancer: a retrospective cohort study in women who were offered scalp cooling. Breast Cancer Res Treat 118:547–552CrossRefPubMed Lemieux J, Amireault C, Provencher L, Maunsell E (2009) Incidence of scalp metastases in breast cancer: a retrospective cohort study in women who were offered scalp cooling. Breast Cancer Res Treat 118:547–552CrossRefPubMed
12.
go back to reference van de Sande MA, van den Hurk CJ, Nreed WP et al (2010) [Allow scalp cooling during adjuvant chemotherapy in patients with breast cancer; scalp metastases rarely occur. Ned Tijdschr Geneeskd 154:A2134PubMed van de Sande MA, van den Hurk CJ, Nreed WP et al (2010) [Allow scalp cooling during adjuvant chemotherapy in patients with breast cancer; scalp metastases rarely occur. Ned Tijdschr Geneeskd 154:A2134PubMed
13.
go back to reference van den Hurk CJG, van de Poll-Franse Breed WPM et al (2013) Scalp cooling to prevent alopecia after chemotherapy can be considered safe in patients with breast cancer. The Breast 22:1001–1004CrossRefPubMed van den Hurk CJG, van de Poll-Franse Breed WPM et al (2013) Scalp cooling to prevent alopecia after chemotherapy can be considered safe in patients with breast cancer. The Breast 22:1001–1004CrossRefPubMed
14.
go back to reference Parker R (1987) The effectiveness of scalp hypothermia in preventing cyclophosphamide-induced alopecia. Oncol Nurs Forum 14:49–53PubMed Parker R (1987) The effectiveness of scalp hypothermia in preventing cyclophosphamide-induced alopecia. Oncol Nurs Forum 14:49–53PubMed
15.
go back to reference Ridderheim M, Bjurberg M, Gustavsson A (2003) Scalp hypothermia to prevent chemotherapy-induced alopecia is effective and safe: a pilot study of a new digitized scalp-cooling system used in 74 patients. Support Cancer Care 11(6):371–377 Ridderheim M, Bjurberg M, Gustavsson A (2003) Scalp hypothermia to prevent chemotherapy-induced alopecia is effective and safe: a pilot study of a new digitized scalp-cooling system used in 74 patients. Support Cancer Care 11(6):371–377
16.
go back to reference Tollenar RAEM, Liefers GJ, Repelaer van Driel OJ et al (1994) Scalp cooling has no place in the prevention of alopecia in adjuvant chemotherapy for breast cancer. Eur J Cancer 30A:1448–1453CrossRef Tollenar RAEM, Liefers GJ, Repelaer van Driel OJ et al (1994) Scalp cooling has no place in the prevention of alopecia in adjuvant chemotherapy for breast cancer. Eur J Cancer 30A:1448–1453CrossRef
18.
go back to reference Protière C, Evans K, Camerio J et al (2002) Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy. Support Care Cancer 10:529–537CrossRefPubMed Protière C, Evans K, Camerio J et al (2002) Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy. Support Care Cancer 10:529–537CrossRefPubMed
19.
go back to reference Ron LG, Kalmus Y, Kalmus Z et al (1997) Scalp cooling in the prevention of alopecia in patients receiving depilating chemotherapy. Support Care Cancer 5:136–138CrossRefPubMed Ron LG, Kalmus Y, Kalmus Z et al (1997) Scalp cooling in the prevention of alopecia in patients receiving depilating chemotherapy. Support Care Cancer 5:136–138CrossRefPubMed
20.
go back to reference Spaëth D, Luporsi E, Weber B et al (2008) Efficacy and safety of cooling helmets (CH) for the prevention of chemotherapy-induced alopecia (CIA): a prospective study of 911 patients (pts). J Clin Oncol 26:9564CrossRef Spaëth D, Luporsi E, Weber B et al (2008) Efficacy and safety of cooling helmets (CH) for the prevention of chemotherapy-induced alopecia (CIA): a prospective study of 911 patients (pts). J Clin Oncol 26:9564CrossRef
21.
go back to reference Christodoulou C, Klouvas G, Efstathiou E et al (2002) Effectiveness of the MSC cold cap system in the prevention of chemotherapy-induced alopecia. Oncology 62:97–102CrossRefPubMed Christodoulou C, Klouvas G, Efstathiou E et al (2002) Effectiveness of the MSC cold cap system in the prevention of chemotherapy-induced alopecia. Oncology 62:97–102CrossRefPubMed
22.
go back to reference Christodoulou C, Tsalakos G, Galani E et al (2006) Scalp metastases and scalp cooling for chemotherapy-induced alopecia prevention. Ann Oncol 17:350CrossRefPubMed Christodoulou C, Tsalakos G, Galani E et al (2006) Scalp metastases and scalp cooling for chemotherapy-induced alopecia prevention. Ann Oncol 17:350CrossRefPubMed
23.
go back to reference Campos-Gomez S, Cruz LR, Morales NC et al (2015) Safety and efficacy of scalp hypothermia to prevent chemotherapy-induced alopecia: a study of a scalp-cooling system used in breast cancer women in a Mexican public hospital. J Clin Oncol 33:e12021 Campos-Gomez S, Cruz LR, Morales NC et al (2015) Safety and efficacy of scalp hypothermia to prevent chemotherapy-induced alopecia: a study of a scalp-cooling system used in breast cancer women in a Mexican public hospital. J Clin Oncol 33:e12021
24.
go back to reference Dean JC, Griffith KS, Cetas TC et al (1983) Scalp hypothermia: a comparison of ice packs and the Kold Kap® in the prevention of doxorubicin-induced alopecia. J Clin Oncol 1(1):33–37CrossRefPubMed Dean JC, Griffith KS, Cetas TC et al (1983) Scalp hypothermia: a comparison of ice packs and the Kold Kap® in the prevention of doxorubicin-induced alopecia. J Clin Oncol 1(1):33–37CrossRefPubMed
25.
go back to reference Massey CS (2004) A multicentre study to determine the efficacy and patient acceptability of the Paxman scalp cooler to prevent hair loss in patients receiving chemotherapy. Eur J Oncol Nurs 8:121–130CrossRefPubMed Massey CS (2004) A multicentre study to determine the efficacy and patient acceptability of the Paxman scalp cooler to prevent hair loss in patients receiving chemotherapy. Eur J Oncol Nurs 8:121–130CrossRefPubMed
26.
go back to reference Middleton J, Franks D, Buchanan RB et al (1985) Failure of scalp hypothermia to prevent hair loss when cyclophosphamide is added to doxorubicin and vincristine. Cancer Treat Rep 69(4):373–375PubMed Middleton J, Franks D, Buchanan RB et al (1985) Failure of scalp hypothermia to prevent hair loss when cyclophosphamide is added to doxorubicin and vincristine. Cancer Treat Rep 69(4):373–375PubMed
27.
go back to reference Peck HJ, Mitchell H, Stewart AL (2000) Evaluating the efficacy of scalp cooling using the Penguin cold cap system to reduce alopecia in patients undergoing chemotherapy for breast cancer. Eur J Oncol Nurs 4(4):246–248CrossRefPubMed Peck HJ, Mitchell H, Stewart AL (2000) Evaluating the efficacy of scalp cooling using the Penguin cold cap system to reduce alopecia in patients undergoing chemotherapy for breast cancer. Eur J Oncol Nurs 4(4):246–248CrossRefPubMed
28.
go back to reference Satterwhite B, Zimm S (1984) The use of scalp hypothermia in the prevention of doxorubicin-induced hair loss. Cancer 54:34–37CrossRefPubMed Satterwhite B, Zimm S (1984) The use of scalp hypothermia in the prevention of doxorubicin-induced hair loss. Cancer 54:34–37CrossRefPubMed
29.
go back to reference van den Hurk CJG, Peerbooms M, van de Poll-Franse LV et al (2012) Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients—results of the Dutch Scalp Cooling Registry. Acta Oncol 51(4):497–504CrossRefPubMed van den Hurk CJG, Peerbooms M, van de Poll-Franse LV et al (2012) Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients—results of the Dutch Scalp Cooling Registry. Acta Oncol 51(4):497–504CrossRefPubMed
30.
go back to reference Nangia J, Wang T, Osborne C et al (2017) Effect of scalp cooling device on alopecia in women undergoing chemotherapy for breast cancer. The SCALP randomized clinical trial. JAMA 317(6):596–605CrossRefPubMed Nangia J, Wang T, Osborne C et al (2017) Effect of scalp cooling device on alopecia in women undergoing chemotherapy for breast cancer. The SCALP randomized clinical trial. JAMA 317(6):596–605CrossRefPubMed
31.
go back to reference Johansen LV (1985) Scalp hypothermia in the prevention of chemotherapy-induced alopecia. Acta Radiol 24:113–116 Johansen LV (1985) Scalp hypothermia in the prevention of chemotherapy-induced alopecia. Acta Radiol 24:113–116
32.
go back to reference Lemenager M, Lecomte S, Bonneterre ME et al (1997) Effectiveness of cold cap in the prevention of docetaxel-induced alopecia. Eur J Cancer 33:297–300CrossRefPubMed Lemenager M, Lecomte S, Bonneterre ME et al (1997) Effectiveness of cold cap in the prevention of docetaxel-induced alopecia. Eur J Cancer 33:297–300CrossRefPubMed
33.
go back to reference Lookingbill DP, Spangler N, Helm KF (1993) Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 29:228–236CrossRefPubMed Lookingbill DP, Spangler N, Helm KF (1993) Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol 29:228–236CrossRefPubMed
34.
go back to reference Kargar M, Sarvestani RS, Khojastech JN, Heidari MT (2011) Efficacy of penguin cap as scalp cooling system for intervention of alopecia in patient undergoing chemotherapy. J Adv Nurs 67(11):2473–2477CrossRefPubMed Kargar M, Sarvestani RS, Khojastech JN, Heidari MT (2011) Efficacy of penguin cap as scalp cooling system for intervention of alopecia in patient undergoing chemotherapy. J Adv Nurs 67(11):2473–2477CrossRefPubMed
35.
go back to reference Tollenar RAEM, Liefers GJ, Repelaer van Driel OJ et al (1994) Scalp cooling has no place in the prevention of alopecia in adjuvant chemotherapy for breast cancer. Eur J Cancer 30A:1448–1453CrossRef Tollenar RAEM, Liefers GJ, Repelaer van Driel OJ et al (1994) Scalp cooling has no place in the prevention of alopecia in adjuvant chemotherapy for breast cancer. Eur J Cancer 30A:1448–1453CrossRef
36.
go back to reference Krathen RA, Orengo IF, Rosen T (2003) Cutaneous metastasis: a meta-analysis of data. South Med J 96(2):164–167CrossRefPubMed Krathen RA, Orengo IF, Rosen T (2003) Cutaneous metastasis: a meta-analysis of data. South Med J 96(2):164–167CrossRefPubMed
37.
go back to reference National Institute for Health and Care Excellence. Early and locally advanced breast cancer: diagnosis and treatment. Clinical Guideline. Published: 25 February 2009. Accessed on 18 Jan 2017 : nice.org.uk/guidance/cg80 National Institute for Health and Care Excellence. Early and locally advanced breast cancer: diagnosis and treatment. Clinical Guideline. Published: 25 February 2009. Accessed on 18 Jan 2017 : nice.org.uk/guidance/cg80
38.
go back to reference Dean JC, Griffith KS, Cetas TC et al (1983) Scalp hypothermia: a comparison of ice packs and the Kold Kap in the prevention of doxorubicin-induced alopecia. J Clin Oncol 1:33–37CrossRefPubMed Dean JC, Griffith KS, Cetas TC et al (1983) Scalp hypothermia: a comparison of ice packs and the Kold Kap in the prevention of doxorubicin-induced alopecia. J Clin Oncol 1:33–37CrossRefPubMed
39.
go back to reference Lemieux J, Desbiens C, Hogue JC (2011) Breast cancer scalp metastasis as first metastatic site after scalp cooling: two cases of occurrence after 7- and 9-year follow up. Breast Cancer Res Treat 128(2):563–566CrossRefPubMed Lemieux J, Desbiens C, Hogue JC (2011) Breast cancer scalp metastasis as first metastatic site after scalp cooling: two cases of occurrence after 7- and 9-year follow up. Breast Cancer Res Treat 128(2):563–566CrossRefPubMed
Metadata
Title
Scalp cooling with adjuvant/neoadjuvant chemotherapy for breast cancer and the risk of scalp metastases: systematic review and meta-analysis
Authors
Hope S. Rugo
Susan A. Melin
Jeff Voigt
Publication date
01-06-2017
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4185-9

Other articles of this Issue 2/2017

Breast Cancer Research and Treatment 2/2017 Go to the issue

Rebuttal Letter

Reply to Munhoz et al.

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine