Abstract

Frailty syndrome is associated with poor outcomes, morbidity and premature mortality. We performed a cross-sectional study to evaluate the presence of frailty syndrome based on Fried’s frailty phenotype in post-menopausal women with breast cancer. We further analyzed the association between frailty syndrome with geriatric assessments and the association with the concentration of gonadotropins LH and FSH, estrogens, androgens and the aromatase activity index in the blood. We enrolled 47 post-menopausal women with localized breast cancer (mean age 66.8 ± 1.3 years (range 52–83)) prior to the starting of adjuvant endocrine therapy. Patients were identified as “non-frail” (robust) or “prefrail/frail” if they fulfilled at least one frailty criteria. In order to determine associations among variables and to control for other variables potentially affecting frailty syndrome (age, comorbidity index and previous chemotherapy treatment), we performed a logistic regression analysis. The receiver operating characteristic curve was performed to assess the sensitivity and specificity of the hormonal concentration to discriminate prefrail/frail versus non-frail individuals. Significant positive associations were observed between the severity of frailty syndrome and estrone, FSH and LH concentrations and the aromatase activity index in the blood (p < 0.05). Further research into the role of hormonal biomarkers should be evaluated in follow-up studies in order to recommend their use as suitable biomarkers of frailty syndrome in breast cancer patients.

Highlights

  • The physiological changes occurring during aging processes increase the risk of malignancies, as well frailty syndrome, which represents a state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems, such that the ability to cope with acute stressors is compromised [4]

  • The rate of prevalence of frailty in our study was lower compared to the data obtained for the Fried frailty syndrome prevalence (9.7% of frail individuals) in the community-dwelling individuals enrolled in the Cardiovascular Health Study [9]

  • The results of our study provide new evidence linking the presence of prefrailty/frailty in women with breast cancer to the alteration of hormonal changes in the blood and the aromatase activity index

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Summary

Introduction

The increased incidence and improved diagnostic and therapeutic interventions over the past decades have led to a rise in the prevalence of oncological diseases among the older patients [1]. The physiological changes occurring during aging processes increase the risk of malignancies, as well frailty syndrome, which represents a state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems, such that the ability to cope with acute stressors is compromised [4]. This syndrome involves physical deterioration and the loss of functions due to the loss of physiological reserves in the process of aging [5]. The pathophysiological basis of frailty syndrome includes several systems such as the immune, muscular and endocrine systems, with the latter including estrogens and androgen hormones [7]

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