Excessive Tearing and Lacrimal and Canalicular Blockage Secondary to Docetaxel in Breast Cancer Patients in the Metastatic and Adjuvant Settings.

While most ophthalmologists and medical oncologists are aware of the excessive tearing and canalicular and lacrimal duct blockage associated with docetaxel, there is lack of deeper understanding of the appropriate management of this side effect and what clinical settings justify surgical intervention as opposed to conservative management. In this review, we summarize the findings in the seminal original research studies that document the association between the frequency of administration of docetaxel and treatment duration and the frequency of excessive tearing as a subjective symptom versus canalicular and lacrimal duct blockage as anatomic findings seen during probing and irrigation. Based on the published literature to date, we note that excessive tearing is a common and important side effect of docetaxel and can be seen in breast cancer patients who are receiving docetaxel either weekly or every three weeks in metastatic or adjuvant settings. However, the anatomic findings of canalicular and lacrimal duct stenosis are almost exclusively seen in patients receiving weekly docetaxel or in patients with metastatic breast cancer who are treated with docetaxel for prolonged periods. Lacrimal duct blockage is much less commonly reported in patients with early breast cancer who are receiving docetaxel every three weeks for short durations and, to our knowledge to date, have not been reported in the literature in breast cancer patients receiving docetaxel in the adjuvant setting.