Taste alterations in patients with breast cancer following chemotherapy: a cohort study



Chemotherapy-induced taste and smell alterations in cancer patients are associated with multiple adverse effects, namely, malnutrition, weight loss, and a diminished quality of life. The aim of this prospective study was to identify the incidence of taste alterations following epirubicin and cyclophosphamide (EC) chemotherapy in patients with breast cancer without previous history of cancer or chemotherapy.


Forty-one patients undergoing EC chemotherapy for breast cancer at Tokai University Hospital were included. A subjective (questionnaire) and an objective (filter paper disk method) assessment for 5 basic tastes were administered on day 4 post-chemotherapy and immediately before the subsequent cycle of chemotherapy for each cycle, in addition to an olfactory evaluation and oral examination. The correlation between subjective and objective taste alterations and factors influencing these alterations were analyzed by statistical means.


The mean incidence of subjective taste alteration on the 4th day after chemotherapy was 53%. In each of the 4 cycles, taste alterations decreased to about 9.0% immediately before the next cycle. A significant correlation between subjective and objective assessments was seen only for salty taste, suggesting important differences in subjective versus objective assessment outcomes. A multivariate analysis indicated that age and body surface area influenced taste alterations.


EC chemotherapy induced taste alterations in more than 50% of patients, which decreased to less than 10% immediately before the next chemotherapy cycle. A combination of objective and subjective assessments is essential to evaluate taste alterations induced by EC chemotherapy. These could be used in routine clinical practice.

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Fig. 1
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Epirubicin and cyclophosphamide


Filter paper disk


The difference in the pre-chemotherapy hemoglobin concentration and the lowest concentration during chemotherapy


Granulocyte-colony-stimulating factor


Recognition threshold


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This study was supported by Japan Society for the Promotion of Science (Grant number: JP17K12020 and JP17H04673) from the Ministry of Education, Culture, Sports, Science and Technology, Japan. The funding body had no role in the design of the study; collection, analysis, or interpretation of the data; writing of the manuscript; or the decision to submit the manuscript for publication.

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YD, NN and NS: wrote the main manuscript text and YD, NS, and TS: contributed to study design; YD, NN, SSK, KY, MT, TM, BT, TO, YO, and YT: contributed to provision of study patients and data collection. All authors reviewed the manuscript.

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Correspondence to Yuya Denda.

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Denda, Y., Niikura, N., Satoh-Kuriwada, S. et al. Taste alterations in patients with breast cancer following chemotherapy: a cohort study. Breast Cancer 27, 954–962 (2020). https://doi.org/10.1007/s12282-020-01089-w

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  • Breast cancer
  • Chemotherapy
  • Cohort study
  • Smell alterations
  • Taste alterations