To synthesize current evidence on postoperative sarcopenia in breast cancer, evaluate its prognostic value, and discuss emerging strategies for prevention and treatment.
Approach:
Epidemiological Evidence: Review of prevalence rates of sarcopenia in breast cancer patients, ranging from 12% to 49%.
Mechanistic Insights: Examination of biological mechanisms linking sarcopenia to treatment outcomes and complications.
Interventional Strategies: Discussion of multimodal interventions including resistance training, protein optimization, and pharmacological approaches.
Key Findings:
Sarcopenia predicts inferior overall and disease-free survival, reduced pathological complete response rates, and increased chemotherapy toxicity.
Muscle metrics combined with inflammatory indices improve prognostic discrimination.
Sarcopenia is potentially modifiable through interventions like resistance training and nutritional support.
Interpretation:
Sarcopenia is a significant factor in breast cancer outcomes, particularly in aggressive subtypes, and its management may improve treatment tolerance and reduce complications.
Limitations:
Diagnostic criteria and assessment methods for sarcopenia are heterogeneous across studies.
Lack of breast cancer-specific randomized evidence for interventions.
Need for standardized perioperative assessment and risk stratification.
Conclusion:
Addressing sarcopenia in breast cancer patients is crucial for improving outcomes, but further research is needed to establish standardized practices.
