Supportive Care in Cancer

, Volume 26, Issue 2, pp 483–489 | Cite as

Madarosis: a qualitative study to assess perceptions and experience of Australian patients with early breast cancer treated with taxane-based chemotherapy

  • K. SmithEmail author
  • J. Winstanley
  • F. Boyle
  • A. O’Reilly
  • M. White
  • Y. C. Antill
Original Article



Eyebrow and eyelash loss (madarosis) is a common and distressing side effect of chemotherapy for which no protective strategies have yet been developed. The purpose of this study was to develop an overview of perceptions and experiences of women undergoing taxane-based treatment for early breast cancer.


A total of 25 women with a diagnosis of invasive early breast cancer participated in a focus group (n = 5), ages ranging from 35 to 64 (median 50), all had completed therapy with a taxane-based chemotherapy treatment. This focus group used targeted questions to explore participants’ perceptions and experience of madarosis during and following chemotherapy and identified issues associated with impact of madarosis on quality of life (QoL). Thematic analysis was conducted to identify important issues experienced by participants.


Seven themes emerged from the data: (1) timing of regrowth and permanent changes, (2) meaning/importance of eyebrow/eyelashes, (3) preparedness/information given, (4) impact of the hair loss of self, (5) impact of hair loss on others, (6) physiological side effects of loss of eyebrows/eyelashes, and (7) management of loss of eyebrows/eyelashes. In addition, participants noted physical symptoms of eye irritation during their treatment that they attributed to madarosis.


This study highlights the significant impact of madarosis on patients, providing the first published analysis of patient’s attitude and perception of eyelash and eyebrow loss during chemotherapy. Further research in this area is required and will be benefitted from the development of a dedicated instrument/questionnaire that can capture and measure the impact of madarosis on QoL and allow development of clinical trial strategies.


Madarosis Quality of life Breast cancer Hair loss Alopecia Questionnaire development 



The Australian and New Zealand Breast Cancer Trials Group provided financial assistance with a $50,000 Category 1 Research-Seed Funding.


  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386CrossRefPubMedGoogle Scholar
  2. 2.
    Coates A, Abraham S, Kaye SB, Sowerbutts T, Frewin C, Fox RM et al (1983) On the receiving end—patient perception of the side-effects of cancer chemotherapy. Eur J Cancer Clin Oncol 19(2):203–208CrossRefPubMedGoogle Scholar
  3. 3.
    Griffin AM, Butow PN, Coates AS, Childs AM, Ellis PM, Dunn SM et al (1996) On the receiving end. V: patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7(2):189–195CrossRefPubMedGoogle Scholar
  4. 4.
    Carelle N, Piotto E, Bellanger A, Germanaud J, Thuillier A, Khayat D (2002) Changing patient perceptions of the side effects of cancer chemotherapy. Cancer 95(1):155–163CrossRefPubMedGoogle Scholar
  5. 5.
    Batchelor D (2001) Hair and cancer chemotherapy: consequences and nursing care—a literature study. Eur J Cancer Care (Engl) 10(3):147–163CrossRefGoogle Scholar
  6. 6.
    Shaw J, Baylock B, O’Reilly A, Winstanley J, Pugliano L, Andrews K et al (2016) Scalp cooling: a qualitative study to assess the perceptions and experiences of Australian patients with breast cancer. Support Care Cancer 24(9):3813–3820CrossRefPubMedGoogle Scholar
  7. 7.
    Jayde V, Boughton M, Blomfield P (2013) The experience of chemotherapy-induced alopecia for Australian women with ovarian cancer. Eur J Cancer Care (Engl) 22(4):503–512CrossRefGoogle Scholar
  8. 8.
    Shin H, Jo SJ, Kim DH, Kwon O, Myung SK (2015) Efficacy of interventions for prevention of chemotherapy-induced alopecia: a systematic review and meta-analysis. Int J Cancer 136(5):E442–E454CrossRefPubMedGoogle Scholar
  9. 9.
    van den Hurk CJ, Peerbooms M, van de Poll-Franse LV, Nortier JW, Coebergh JW, Breed WP (2012) Scalp cooling for hair preservation and associated characteristics in 1411 chemotherapy patients—results of the Dutch Scalp Cooling Registry. Acta Oncol 51(4):497–504CrossRefPubMedGoogle Scholar
  10. 10.
    Protiere C, Evans K, Camerlo J, d’Ingrado MP, Macquart-Moulin G, Viens P et al (2002) Efficacy and tolerance of a scalp-cooling system for prevention of hair loss and the experience of breast cancer patients treated by adjuvant chemotherapy. Support Care Cancer 10(7):529–537CrossRefPubMedGoogle Scholar
  11. 11.
    Hwang K (2013) Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol 46(2):93–100CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Khong JJ, Casson RJ, Huilgol SC, Selva D (2006) Madarosis. Surv Ophthalmol 51(6):550–560CrossRefPubMedGoogle Scholar
  13. 13.
    Elder MJ (1997) Anatomy and physiology of eyelash follicles: relevance to lash ablation procedures. Ophthal Plast Reconstr Surg 13(1):21–25CrossRefPubMedGoogle Scholar
  14. 14.
    Hunt N, McHale S (2005) The psychological impact of alopecia. BMJ 331(7522):951–953CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Morris CL, Stinnett S, Woodward J (2011) The role of bimatoprost eyelash gel in chemotherapy-induced madarosis: an analysis of efficacy and safety. Int J Trichology 3(2):84–91CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ahluwalia GS (2013) Safety and efficacy of bimatoprost solution 0.03% topical application in patients with chemotherapy-induced eyelash loss. J Investig Dermatol Symp Proc 16(1):S73–S76CrossRefPubMedGoogle Scholar
  17. 17.
    Yoelin S, Walt JG, Earl M (2010) Safety, effectiveness, and subjective experience with topical bimatoprost 0.03% for eyelash growth. Dermatol Surg 36(5):638–649CrossRefPubMedGoogle Scholar
  18. 18.
    Moore DKD, Richtig E (2015) Bimatoprost 0.3mg/ml ophthalmic solution for lash growth—pilot study, half side trial. Glob Dermal 2(3):109–111Google Scholar
  19. 19.
    Smith S, Fagien S, Whitcup SM, Ledon F, Somogyi C, Weng E et al (2012) Eyelash growth in subjects treated with bimatoprost: a multicenter, randomized, double-masked, vehicle-controlled, parallel-group study. J Am Acad Dermatol 66(5):801–806CrossRefPubMedGoogle Scholar
  20. 20.
    Kwon O, Kim JY, Paik SH, Jeon HC, Jung YJ, Lee Y et al (2014) Long-term utility and durability of the therapeutic effects of bimatoprost 0.03% for eyelash augmentation in healthy Asian subjects. Dermatology 229(3):222–229CrossRefPubMedGoogle Scholar
  21. 21.
    Blume-Peytavi U, Lonnfors S, Hillmann K, Garcia BN (2012) A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia. J Am Acad Dermatol 66(5):794–800CrossRefPubMedGoogle Scholar
  22. 22.
    Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD et al (2001) Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol 119(7):1050–1058CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Cabrini Hospital, Medical OncologyMelbourneAustralia
  2. 2.Peter MacCallum Cancer Centre, Medical OncologyMelbourneAustralia
  3. 3.Patricia Ritchie Centre for Cancer Care and ResearchUniversity of Sydney—The Mater Hospital, Medical OncologySydneyAustralia
  4. 4.Monash Medical Centre, Medical OncologyMelbourneAustralia

Personalised recommendations