Racial and Ethnic Disparities in Persistent Chemotherapy-Induced Alopecia Among Women With Breast Cancer

Area of Science:

• Oncology
• Dermatology
• Psychosocial Oncology

Background:

• Persistent chemotherapy-induced alopecia (PCIA) is a distressing side effect of cancer treatment.
• Existing data on racial and ethnic differences in PCIA incidence and associated distress are limited.
• Understanding these disparities is crucial for equitable patient care and support.

Purpose of the Study:

• To investigate racial and ethnic disparities in PCIA incidence among women with breast cancer.
• To evaluate differences in alopecia-related psychological distress across racial and ethnic groups.
• To track these outcomes from baseline up to 12 months post-chemotherapy.

Main Methods:

• Prospective multinational cohort study involving women with breast cancer undergoing chemotherapy.
• Trichoscopic assessments and validated distress questionnaires (Chemotherapy-Induced Alopecia Distress Scale - CADS) were administered.
• Data collected at baseline and 12 months post-chemotherapy, with analysis conducted in 2025.

Main Results:

• PCIA incidence was highest in Asian women (42.1%), followed by White (22.2%), Black (10.0%), and Hispanic/Latino (5.1%) women.
• Asian women exhibited the thickest hair shafts at baseline but the lowest follicular density.
• Asian women reported the greatest increase in CADS scores, particularly in emotional and activity-related domains, compared to White women.

Conclusions:

• Significant racial and ethnic disparities exist in both the incidence and psychological impact of PCIA.
• Asian women bear the greatest burden of PCIA and associated distress.
• Findings necessitate personalized counseling, culturally sensitive psychosocial support, and consideration of pharmacogenetic factors in managing chemotherapy-related alopecia.