Hope S Rugo1, Susan A. Melin2, Jeff Voigt3
1University of California San Francisco Helen Diller Family Comprehensive Cancer Center, UCSF Medical Center at Mount Zion, 1600 Divisadero St, San Francisco, CA 94115 USA
2Wake Forest University Baptist Medical Center, Medical Center Blvd, Fl 3, Winston Salem, NC 27157 US
3Medical Device Consultants Ridgewood, LLC, 99 Glenwood Rd, Ridgewood, NJ 07450 USA
A systematic review and meta-analysis evaluated the risk of scalp metastases in breast cancer chemotherapy patients undergoing and not undergoing scalp cooling. Several electronic databases were searched for information relating to chemotherapy, breast cancer and scalp metastases.
Timing of chemotherapy: Adjuvant chemotherapy patients included.
3197 breast cancer patients treated with chemotherapy, both with and without the use of scalp cooling. Patients who did not have enough follow up information were excluded from the study.
Scalp metastases incidence rates were found to be very low for both groups. After following the scalp cooled and non-scalp cooled patients for an estimated mean average of 43.14 and 87.4 months respectively, in total the study found 17 cases of scalp metastases in 3197 patients. Only 0.61% of the scalp cooled group and 0.4% of the non-scalp cooled group showed signs of scalp metastases, therefore showing no statistical difference between the groups. This study is in agreement with van den Hurk et al. (2013b) showing a low incidence rate of scalp metastases in general and that scalp cooling does not increase the risk of scalp metastases.
Retrospective studies use pre-recorded data, therefore most studies used did not specifically assess scalp metastasis as a primary end point. The follow up time is presented as an estimated weighted mean. This is due to the times varying between each patient, however the average is thought to be a good representation of the follow up time, as the groups were large, and the distribution was assumed to be normal.
