Abstract
Sarcopenia is a geriatric syndrome characterized by losses of quantity and quality of skeletal muscle, which is associated with negative outcomes in older adults and in cancer patients. Different definitions of sarcopenia have been used, with quantitative data more frequently used in oncology, while functional measures have been advocated in the geriatric literature. Little is known about the correlation between frailty status as assessed by comprehensive geriatric assessment (CGA) and sarcopenia in cancer patients. We retrospectively analyzed data from 96 older women with early breast cancer who underwent CGAs and Dual X-ray Absorptiometry (DXA) scans for muscle mass assessment before cancer treatment at a single cancer center from 2016 to 2019 to explore the correlation between frailty status as assessed by CGA and sarcopenia using different definitions. Based on the results of the CGA, 35 patients (36.5%) were defined as frail. Using DXA Appendicular Skeletal Mass (ASM) or the Skeletal Muscle Index (SMI=ASM/height^2), 41 patients were found to be sarcopenic (42.7%), with no significant difference in prevalence between frail and nonfrail subjects. Using the European Working Group on Sarcopenia in Older People (EWGSOP2) definition of sarcopenia (where both muscle function and mass are required), 58 patients were classified as “probably” sarcopenic; among these, 25 were sarcopenic and 17 “severely” sarcopenic. Only 13 patients satisfied both the requirements for being defined as sarcopenic and frail. Grade 3-4 treatment-related toxicities (according to Common Terminology Criteria for Adverse Events) were more common in sarcopenic and frail sarcopenic patients. Our data support the use of a definition of sarcopenia that includes both quantitative and functional data in order to identify frail patients who need tailored treatment.
Highlights
Breast cancer is the most frequent cancer diagnosed in women and the leading cause of cancer death among women [1]
The medium age of the examined sample was 76.9 (70 ÷ 89; SD 4.586), with an average level of comorbidity measured by the Charlson Comorbidity Index (CCI) of 6.7 (5 ÷ 13; SD—1.904), while ECOG performance status was mainly between 0 and 1 (89.6% of patients)
It has become essential to know the differences between sarcopenia and the loss of muscle mass related to the normal process of muscle aging or other pathological conditions such as cachexia [30]
Summary
Breast cancer is the most frequent cancer diagnosed in women and the leading cause of cancer death among women [1]. Chronological age per se is a misleading criterion when deciding the best treatment for older women with breast cancer. A group of older patients with the same cancer of identical chronologic age can demonstrate wide heterogeneity concerning vitality, comorbidity, functional status, physiologic reserve, and psychosocial functioning [3,4,5]. The accrual of older adults in cancer trials has been poor and undermined by several barriers through the years [6]. This is a severe matter of concern when evidence-based guidelines are applied to older populations, with negative consequences on survival [7]. A personalized approach based on individual patients’ clinical conditions and functionality rather than age [8,9,10,11] should be considered the standard of care for older women with breast cancer
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
