title: Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients.
abstract: BACKGROUND
  Anagen effluvium with reversible scalp alopecia is a known side effect of chemotherapy. However, there are an increasing number of reports in the literature documenting permanent alopecia in patients treated with taxanes.
  
  
  OBJECTIVE
  We sought to describe the clinicopathologic features in breast cancer patients who underwent treatment with taxanes and adjuvant hormonal chemotherapy.
  
  
  METHODS
  We reviewed the clinical and histopathologic information of a cohort of 10 patients treated with taxanes and adjuvant hormonal chemotherapy.
  
  
  RESULTS
  We have observed 3 types of clinical patterns of alopecia (types A, B, and C), and have validated the histopathologic features showing alopecia areata-like and female pattern hair loss.
  
  
  CONCLUSIONS
  The study was based on a small sample size and retrospective retrieval of clinical information and histopathologic review of posttreatment slides.
  
  
  CONCLUSIONS
  We hypothesize a clinicopathologic model of hair follicle cycle disruption in response to the chemoinflammatory and hormonal insults to the hair follicles resulting in permanent alopecia. Clinicopathologic correlation is paramount to the understanding of the morphobiologic pathways in chemotherapy-induced alopecia caused by taxanes and adjuvant hormonal treatment.
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Athina
authors.initials: A
authors.lastname: Fonia
authors.affiliation: Institute of San Gallicano, Istituti Fisioterapici Ospitalieri, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cota
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom; St Mary's Hospital, Imperial College NHS Healthcare Trust, London, United Kingdom.
authors.forename: Jane F
authors.initials: JF
authors.lastname: Setterfield
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Lynne J
authors.initials: LJ
authors.lastname: Goldberg
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: David A
authors.initials: DA
authors.lastname: Fenton
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom; Department of Dermatopathology, St John's Institute of Dermatology, NHS Foundation Trust, Guy's and St Thomas' Hospital, London, United Kingdom. Electronic address: catherinestefanato@gmail.com.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Stefanato
mesh_terms: D000368:Aged; D000505:Alopecia / Q000139:chemically induced* / Q000473:pathology*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D001952:Bridged-Ring Compounds / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005260:Female; D018859:Hair Follicle / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D043823:Taxoids / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane
keywords: alopecia; breast cancer; clinicopathologic correlation; coadjuvant hormonal therapy; histopathology; tamoxifen; taxanes