To the Editor: Alopecia is feared by most patients
undergoing systemic anticancer therapy for breast
cancer because of its negative impact on quality of
life.1 Currently, evidence regarding management of
persistent chemotherapy-induced alopecia ( pCIA)
and endocrine therapy-induced alopecia (EIA) in
patients with breast cancer is lacking.2-4 Although
previous studies demonstrated successful use of lowdose oral minoxidil (LDOM) in pCIA, EIA was not
included, and responses were assessed only by
evaluating clinical photographs.2,3 Therefore, using
quantitative measurements, we assessed the efficacy
of LDOM in patients with breast cancer diagnosed
with pCIA and/or EIA.
We retrospectively reviewed medical records,
standardized clinical photographs, and trichoscopic
images (Folliscope5.0, LeadM) to assess the alopecia
pattern, severity, treatment response, and posttreatment changes in vertex hair density and thickness. Alopecia severity was evaluated using the
Common Terminology Criteria for Adverse Events,
version 5.0.2 For patients who received both chemotherapy and endocrine therapy, EIA was diagnosed
when there was complete hair regrowth prior to
alopecia aggravation postinitiation of endocrine
therapy. Combined pCIA and EIA was defined as
incomplete hair regrowth 6 months after chemotherapy completion with alopecia aggravation postinitiation of endocrine therapy

https://www.sciencedirect.com/science/article/abs/pii/S0190962222032613