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Scalp cooling is a widely used method to prevent chemotherapy-induced transient alopecia. Although the success rates in maintaining hair can be high, authors have expressed their concerns regarding the risk of scalp metastasis after scalp cooling. We report a case of breast cancer scalp metastasis in a patient submitted to scalp cooling for alopecia prevention and discuss the physiopathology, risks and benefits of this treatment for patients under this treatment.doi:10.4236/jct.2020.1111064 fatcat:ksgjy76cnjhbfefwgadfzev264