title: Analysis of quantitative changes in hair growth during treatment with chemotherapy or tamoxifen in patients with breast cancer: a cohort study.
abstract: BACKGROUND
  In women with breast cancer, chemotherapy-induced alopecia is a highly feared but common side-effect of antineoplastic treatment. The onset, pattern and amount of hair loss differ depending on the therapy regimen and have not yet been quantified using standardized techniques.
  
  
  OBJECTIVE
  To evaluate objectively and compare the effect of antineoplastic therapy with chemotherapy or tamoxifen on hair loss, quantifying trichological parameters.
  
  
  METHODS
  Female patients with breast cancer were included (n = 34), who were receiving chemotherapy (group C, n = 17) or tamoxifen (group T, n = 17) after surgery. Trichological parameters were evaluated once before [week 0 (w0)], twice during (w3, w6) and twice after (w18, w28) the normal 16-week course of chemotherapy, or at corresponding time points during continuous tamoxifen intake. At each visit, anagen and telogen hairs and hair density were quantified by automated phototrichogram in two defined areas: frontal and occipital.
  
  
  RESULTS
  Group T generally showed no changes in anagen and telogen hairs or hair density. In group C, anagen hairs and hair density generally followed the same course, decreasing until w6, remaining at a low level during w6-18 and increasing after cessation of chemotherapy, reaching values comparable with or higher than baseline at w28. Telogen hairs increased until w3 then decreased until w6, remaining stable afterwards.
  
  
  CONCLUSIONS
  Diffuse hair loss begins shortly after initiation of chemotherapy, mainly as anagen effluvium, with a proportion of anagen to telogen conversion. Hair loss is most prominent after 6 weeks of chemotherapy. Within 3 months after cessation of chemotherapy, hair growth rate returns to baseline values. Tamoxifen did not affect hair growth parameters.
authors.affiliation: Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Kanti
authors.forename: R
authors.initials: R
authors.lastname: Nuwayhid
authors.forename: J
authors.initials: J
authors.lastname: Lindner
authors.forename: K
authors.initials: K
authors.lastname: Hillmann
authors.forename: A
authors.initials: A
authors.lastname: Stroux
authors.forename: N
authors.initials: N
authors.lastname: Bangemann
authors.forename: A
authors.initials: A
authors.lastname: Kleine-Tebbe
authors.forename: U
authors.initials: U
authors.lastname: Blume-Peytavi
authors.forename: N
authors.initials: N
authors.lastname: Garcia Bartels
mesh_terms: D000505:Alopecia / Q000139:chemically induced; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006197:Hair / Q000187:drug effects / Q000254:growth & development; D006801:Humans; D008875:Middle Aged; D010781:Photography; D011446:Prospective Studies; D013629:Tamoxifen / Q000009:adverse effects*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen