Pectoralis muscle index might be a factor associated with frailty in older women with breast cancer

Authors: MUHAMMET CEMAL KIZILARSLANOĞLU, M. ALİ ERYILMAZ, BETÜL ÇİĞDEM YORTANLI, İLKNUR RAHİME ÜNAL, BARIŞ CAN ÜNAL, NAHİDE BARAN, AYŞEGÜL ALTUNKESER, NERGİS AKSOY

Abstract: Background/aim: To investigate the possible relationship between pectoralis muscle (PM) measurement and frailty in older women with breast cancer (BC) (preoperatively defined as stage 1, 2, and 3 diseases). Materials and methods: This retrospective, observational study was conducted at Konya Training and Research Hospital between June and December 2020. A total of 102 patients [median age 62.5 years, median follow-up period two years] were included in the study. PM measurements were obtained from thorax computerized tomography (CT). Pectoralis muscle index (PMI) was calculated by dividing the PM area by the height square of the patients (cm2/m2). Pectoralis muscle density (PMD) was evaluated using CT findings, including their Hounsfield Units (HU). Frailty status and sarcopenia-risk assessments were done by a telephone interview in September 2020 using the FRAIL index (categorized as robust or nonrobust) and SARC-F questionnaire (classified as no sarcopenia-risk or risk of sarcopenia), respectively. PM measurements were compared between robust and nonrobust patients and between patients with a risk of sarcopenia and no sarcopenia risk. Results: The nonrobust patients had lower pectoralis major muscle index (PMaMI) (p = 0.041) and pectoralis major muscle density (PMaD) (p = 0.020) levels than robust patients in the whole study sample. PMI (p = 0.017) and PMaMI (p = 0.010) levels were significantly lower in the nonrobust patients than in robust patients with early-stage BC. Frailty status was positively correlated with age (rho: 0.621; p < 0.001), BC stage (rho: 0.220; p = 0.026), and SARC-F score (rho: 0.747; p < 0.001), and negatively correlated with PMaMI (rho: -0.197; p = 0.047) and PMaD (rho: -0.237; p = 0.016). There were significant associations between PMaMI (OR: 0.467, 95% Confidence Interval (CI): 0.226-0.962 p = 0.039) and PMI (OR: 0.543, 95% CI: 0.299-0.986 p = 0.045) levels with frailty status (being nonrobust) in regression models. Conclusion: In the study, it has been shown that pectoralis muscle assessment might be a related parameter to frailty in older women with breast cancer.

Keywords: Breast cancer, frailty, pectoralis muscle, sarcopenia

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