Scalp Cooling with Adjuvant/neoadjuvant Chemotherapy for Breast Cancer and the Risk of Scalp Metastases: Systematic Review and Meta-analysis

Overview

Journal Breast Cancer Res Treat

Specialty Oncology

Date 2017 Mar 10

PMID 28275922

Citations 29

Authors

Hope S Rugo

Susan A Melin

Jeff Voigt

Affiliations

Soon will be listed here.

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.

Citing Articles

Use of scalp cooling therapy in patients with breast or gynecological cancers undergoing chemotherapy may be associated with a higher risk of systemic recurrence.

Altundag K Support Care Cancer. 2025; 33(1):70.

PMID: 39757330 DOI: 10.1007/s00520-025-09151-z.

Therapeutic Effect of Superficial Scalp Hypothermia on Chemotherapy-Induced Alopecia in Breast Cancer Survivors.

Mokbel K, Kodresko A, Trembley J, Jouhara H J Clin Med. 2024; 13(18).

PMID: 39336884 PMC: 11432742. DOI: 10.3390/jcm13185397.

Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention.

Perez A, Haberland N, Miteva M, Wikramanayake T Curr Oncol. 2024; 31(9):5709-5721.

PMID: 39330051 PMC: 11431623. DOI: 10.3390/curroncol31090423.

The Efficacy of Paxman Scalp Cooling System in Preventing Hair Loss in Breast Cancer Patients Receiving Chemotherapy in Western India - Multi-centre Retrospective Cohort Study.

Mekha M, Joshi A, Maniar V, Maheshwari U, Joshi K, Kalaskar P Indian J Dermatol. 2024; 69(1):16-23.

PMID: 38572038 PMC: 10986862. DOI: 10.4103/ijd.ijd_345_23.

Breast cancer with scalp metastases: a case report.

Abdulraheem A, Naji D, Al Heyasat A, Alhasan M, Almasri N, Odeh R J Med Case Rep. 2023; 17(1):203.

PMID: 37198611 PMC: 10193700. DOI: 10.1186/s13256-023-03928-8.

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