Measuring Sarcopenia on MRI among Turkish Female Breast Cancer Patients The sarcopenia measurement with breast MRI

Gulten Sezgin (1), Kazim Ayberk Sinci (2), Melda Apaydin (3), Sebnem Karasu (4), Ferhan Elmali (5)
(1) Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Radiology, Izmir, Turkey, Turkey,
(2) Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Radiology, Izmir, Turkey., Turkey,
(3) Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Radiology, Izmir, Turkey., Turkey,
(4) Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Radiology, Izmir, Turkey., Turkey,
(5) Izmir Katip Celebi University Faculty of Medical, Department of Biostatistic, Izmir, Turkey., Turkey


Background: Since the presence of sarcopenia in breast cancer patients is associated with increased postoperative complications, it is crucial to know its frequency in the prechemoteraphy period. It has been suggested that there are many factors associated with sarcopenia. This study focused on the frequency of sarcopenia over the pectoralis muscle area obtained in routine breast MRI among Turkish females who were newly diagnosed with breast cancer.

Methods: In a prospective study, pectoralis muscle was manually contoured bilaterally, and the cross-sectional area on breast MRI was calculated in newly diagnosed breast cancer patients. The 'Core slices' program was used while calculating SMI. We accepted 7.4 kg/m2 as the threshold value for sarcopenia.

Results: Overall, 17 patients (17 %) were sarcopenic. The analysis regarding the detection of sarcopenia in the patient groups < 65 and ≥ 65 years of age was not statistically significant (P<0.156). The relationship between the groups with BMI < 25 and ≥ 25 sarcopenia was statistically significant (P<0.001). Sarcopenia was found significantly more frequently in patients with metastasis (P<0,0001).

Conclusion: This study recruited Turkish females who were newly diagnosed breast cancer. It is the first study in the literature to include the same race, gender, and malignancy in which sarcopenia was investigated. It was shown that breast MRI which is radiation-free can be used in the evaluation of sarcopenia in patients with breast cancer. This result is important for being prepared for possible complications before treatment.

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Del Fabbro E, Parsons H, Warneke CL, Pulivarthi K, Litton JK, Dev R, et al. The relationship between body composition and response to neoadjuvant chemotherapy in women with operable breast cancer. Oncologist. 2012;17(10):1240-5.

Prado CM, Baracos VE, McCargar LJ, Reiman T, Mourtzakis M, Tonkin K, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15(8):2920-6.

Deluche E, Leobon S, Desport JC, Venat-Bouvet L, Usseglio J, Tubiana-Mathieu N. Impact of body composition on outcome in patients with early breast cancer. Support Care Cancer. 2018;26(3):861-8.

Klassen O, Schmidt ME, Ulrich CM, Schneeweiss A, Potthoff K, Steindorf K, et al. Muscle strength in breast cancer patients receiving different treatment regimes. J Cachexia Sarcopenia Muscle. 2017;8(2):305-16.

Villaseñor A, Ballard-Barbash R, Baumgartner K, Baumgartner R, Bernstein L, McTiernan A, et al. Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL Study. J Cancer Surviv. 2012;6(4):398-406.

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23.

Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249-56.

Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM, Biolo G, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) "cachexia-anorexia in chronic wasting diseases" and "nutrition in geriatrics". Clin Nutr. 2010;29(2):154-9.

Morley JE, Abbatecola AM, Argiles JM, Baracos V, Bauer J, Bhasin S, et al. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc. 2011;12(6):403-9.

Rossi F, Valdora F, Barabino E, Calabrese M, Tagliafico AS. Muscle mass estimation on breast magnetic resonance imaging in breast cancer patients: comparison between psoas muscle area on computer tomography and pectoralis muscle area on MRI. Eur Radiol. 2019;29(2):494-500.

Mann RM, Cho N, Moy L. Breast MRI: State of the Art. Radiology. 2019;292(3):520-36.

Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS, Kose M, et al. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr. 2016;35(6):1557-63.

Oflazoglu U, Alacacioglu A, Varol U, Kucukzeybek Y, Salman T, Taskaynatan H, et al. Prevalence and related factors of sarcopenia in newly diagnosed cancer patients. Support Care Cancer. 2020;28(2):837-43.

Tan BH, Birdsell LA, Martin L, Baracos VE, Fearon KC. Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res. 2009;15(22):6973-9.

Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9(7):629-35.

Jung HW, Kim JW, Kim JY, Kim SW, Yang HK, Lee JW, et al. Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy. Support Care Cancer. 2015;23(3):687-94.

Prado CM, Lieffers JR, Bowthorpe L, Baracos VE, Mourtzakis M, McCargar LJ. Sarcopenia and physical function in overweight patients with advanced cancer. Can J Diet Pract Res. 2013;74(2):69-74.

Wang SL, Zhuang CL, Huang DD, Pang WY, Lou N, Chen FF, et al. Sarcopenia Adversely Impacts Postoperative Clinical Outcomes Following Gastrectomy in Patients with Gastric Cancer: A Prospective Study. Ann Surg Oncol. 2016;23(2):556-64.

Huang DD, Wang SL, Zhuang CL, Zheng BS, Lu JX, Chen FF, et al. Sarcopenia, as defined by low muscle mass, strength and physical performance, predicts complications after surgery for colorectal cancer. Colorectal Dis. 2015;17(11):O256-64.

Shachar SS, Williams GR, Muss HB, Nishijima TF. Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review. Eur J Cancer. 2016;57:58-67.

Pamoukdjian F, Bouillet T, Lévy V, Soussan M, Zelek L, Paillaud E. Prevalence and predictive value of pre-therapeutic sarcopenia in cancer patients: A systematic review. Clin Nutr. 2018;37(4):1101-13.

Group UCSW. US cancer statistics: 1999–2009 incidence and mortality web-based report. Atlanta GA: USDHHS, CDC and National Cancer Institute. 2013.

Sayer AA, Syddall H, Martin H, Patel H, Baylis D, Cooper C. The developmental origins of sarcopenia. J Nutr Health Aging. 2008;12(7):427-32.

Paddon-Jones D, Short KR, Campbell WW, Volpi E, Wolfe RR. Role of dietary protein in the sarcopenia of aging. Am J Clin Nutr. 2008;87(5):1562s-6s.

Kim EY, Kim K, Kim YS, Ahn HK, Jeong YM, Kim JH, et al. Prevalence of and Factors Associated with Sarcopenia in Korean Cancer Survivors: Based on Data Obtained by the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011. Nutr Cancer. 2017;69(3):394-401.

Broughman JR, Williams GR, Deal AM, Yu H, Nyrop KA, Alston SM, et al. Prevalence of sarcopenia in older patients with colorectal cancer. Journal of geriatric oncology. 2015;6(6):442-5.

Zhang X-M, Dou Q-L, Zeng Y, Yang Y, Cheng AS, Zhang W-W. Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review. BMC cancer. 2020;20:1-11.


Gulten Sezgin (Primary Contact)
Kazim Ayberk Sinci
Melda Apaydin
Sebnem Karasu
Ferhan Elmali
Sezgin G, Sinci KA, Apaydin M, Karasu S, Elmali F. Measuring Sarcopenia on MRI among Turkish Female Breast Cancer Patients: The sarcopenia measurement with breast MRI . Arch Breast Cancer [Internet]. 2023 Mar. 30 [cited 2024 Jul. 16];10(2):159-63. Available from:

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