Sarcopenia in Breast Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

(1) Background: We estimated the prevalence and clinical outcomes of sarcopenia among breast cancer patients. (2) Methods: A systematic literature search was carried out for the period between July 2023 and October 2023. Studies with breast cancer patients evaluated for sarcopenia in relation to overall survival (OS), progression-free survival (PFS), relapse of disease (DFS), pathological complete response (pCR), or toxicity to chemotherapy were included. (3) Results: Out of 359 screened studies, 16 were eligible for meta-analysis, including 6130 patients, of whom 5284 with non-MBC. Sarcopenia was evaluated with the computed tomography (CT) scan skeletal muscle index and, in two studies, with the dual-energy x-ray absorptiometry (DEXA) appendicular lean mass index. Using different classifications and cut-off points, overall, there were 2007 sarcopenic patients (33%), of whom 1901 (95%) presented with non-MBC. Sarcopenia was associated with a 33% and 29% higher risk of mortality and progression/relapse of disease, respectively. Sarcopenic patients were more likely to develop grade 3–4 toxicity (OR 3.58, 95% CI 2.11–6.06, p < 0.0001). In the neoadjuvant setting, a higher rate of pCR was observed among sarcopenic patients (49%) (OR 2.74, 95% CI 0.92–8.22). (4) Conclusions: Our meta-analysis confirms the correlation between sarcopenia and negative outcomes, especially in terms of higher toxicity.

Long-Term High-Fat Diet Limits the Protective Effect of Spontaneous Physical Activity on Mammary Carcinogenesis

“…Conversely, mice under LT HFD presented more visceral adipose tissue, less total hind leg muscle mass, and higher tumour growth. These data are in line with recent studies reporting that muscle loss may adversely affect breast cancer patient outcomes, independently from malnutrition [ 44 ]. Moreover, the muscle mass variation observed could be an interesting perspective to follow the low but real prevalence of sarcopenia in women with breast cancer [ 45 ].…”

Assessment of body composition in breast cancer patients: concordance between transverse computed tomography analysis at the fourth thoracic and third lumbar vertebrae

“…Proposed mechanisms include later diagnosis, more aggressive tumour types, and suboptimal chemotherapy treatment ( 8 – 11 ). Patients with cancer are at risk of developing sarcopenia and cancer cachexia, which is associated with a poorer prognosis in terms of recurrence, survival, and treatment toxicity ( 12 ). The processes underlying these changes in body composition are not fully understood but result from both cancer and treatment effects ( 13 ).…”