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Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy
Open accessAbstract
Background Low muscle mass (LMM) and low muscle attenuation (LMA) reflect low muscle quantity and low muscle quality, respectively. Both are associated with a poor outcome in several types of solid malignancies. This study determined the association of skeletal muscle measures with overall survival (OS) and time to next treatment (TNT). Patients and methods A skeletal muscle index (SMI) in cm 2 /m 2 and muscle attenuation (MA) in Hounsfield units (HU) were measured using abdominal CT-images of 166 patients before start of first-line chemotherapy for metastatic breast cancer. Low muscle mass (SMI <41 cm 2 /m 2 ), sarcopenic obesity (LMM and BMI ≥30 kg/m 2 ) and low muscle attenuation (MA <41 HU and BMI <25 kg/m2 or MA <33 HU and BMI ≥25 kg/m2) were related to OS and TNT. Results The prevalence of LMM, sarcopenic obesity and LMA were 66.9%, 7.2% and 59.6% respectively. LMM and sarcopenic obesity showed no significant association with OS and TNT, whereas LMA was associated with both lower OS (HR 2.04, 95% CI 1.34–3.12, p = 0.001) and shorter TNT (HR 1.72, 95% CI 1.14–2.62, p = 0.010). Patients with LMA had a median OS and TNT of 15 and 8 months respectively, compared to 23 and 10 months in patients with normal MA. Conclusion LMA is a prognostic factor for OS and TNT in metastatic breast cancer patients receiving first-line palliative chemotherapy, whereas LMM and sarcopenic obesity are not. Further research is needed to establish what impact LMA should have in daily clinical practice.
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“reported associations indicate a stronger link of muscle fat with adverse outcomes as compared with muscle quantity.60,61,[65][66][67]”
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Cites
Sarcopenia: European consensus on definition and diagnosis
Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., Martin, F. C., Michel, J.-P., Rolland, Y., Schneider, S. M., et al. (2010) · Age and Ageing · doi:10.1093/ageing/afq034 · Cited by 11,601
Epidemiology of Sarcopenia among the Elderly in New Mexico
Baumgartner, R. N., Koehler, K. M., Gallagher, D., Romero, L., Heymsfield, S. B., Ross, R. R., Garry, P. J., & Lindeman, R. D. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009520 · Cited by 4,004
Prado, C. M., Lieffers, J. R., McCargar, L. J., Reiman, T., Sawyer, M. B., Martin, L., & Baracos, V. E. (2008) · The Lancet Oncology · doi:10.1016/s1470-2045(08)70153-0 · Cited by 3,238
Martin, L., Birdsell, L., Macdonald, N., Reiman, T., Clandinin, M. T., McCargar, L. J., Murphy, R. A., Ghosh, S., Sawyer, M. B., & Baracos, V. E. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.45.2722 · Cited by 2,761
Shen, W., Punyanitya, M., Wang, Z., Gallagher, D., St.-Onge, M.-P., Albu, J., Heymsfield, S. B., & Heshka, S. (2004) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00744.2004 · Cited by 1,692
Newman, A. B., Kupelian, V., Visser, M., Simonsick, E. M., Goodpaster, B. H., Kritchevsky, S. B., Tylavsky, F. A., Rubin, S. M., Harris, T. B., & on Behalf of the Health, A. A. B. C. S. I. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.1.72 · Cited by 1,692
Attenuation of skeletal muscle and strength in the elderly: the Health ABC Study
Goodpaster, B. H., Carlson, C. L., Visser, M., Kelley, D. E., Scherzinger, A., Harris, T. B., Stamm, E., & Newman, A. B. (2001) · Journal of Applied Physiology · doi:10.1152/jappl.2001.90.6.2157 · Cited by 1,226
Prado, C. M. M., Baracos, V. E., McCargar, L. J., Reiman, T., Mourtzakis, M., Tonkin, K. S., Mackey, J. R., Koski, S. L., Pituskin, E., & Sawyer, M. B. (2009) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-08-2242 · Cited by 1,125
Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review
Shachar, S. S., Williams, G. R., Muss, H. B., & Nishijima, T. F. (2016) · European Journal of Cancer · doi:10.1016/j.ejca.2015.12.030 · Cited by 1,125
Delmonico, M. J., Harris, T. B., Lee, J., Visser, M., Nevitt, M., Kritchevsky, S. B., Tylavsky, F. A., Newman, A. B., & for the Health, A. A. B. C. S. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01140.x · Cited by 819
Research works printed but not linked: 1
- Cruz-Jentoft, 2014, Prevalence of and interventions for sarcopenia in ageing adults: a systematic review, Rep Int Sarcopenia Initiat. EWGSOP IWGS, 43, 748
Cited by
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Items 101–149 of 149
Aduse‐Poku, L., Bian, J., Gopireddy, D. R., Hernandez, M., Lall, C. G., Falzarano, S. M., Masood, S., Jo, A., & Cheng, T. D. (2022) · Cancers · doi:10.3390/cancers14071846 · Cited by 8
Aktaş, A., Greiner, R. S., Flores, M., Boselli, D. M., Stone, T. J., Wang, E. W., Hadžikadić-Gušić, L., Wallander, M. L., Hecksher, A., Bailey-Dorton, C. M., et al. (2024) · Clinical Breast Cancer · doi:10.1016/j.clbc.2024.10.014 · Cited by 8
The impact of sarcopenic obesity on cancer clinical outcomes
Köylü, B., Sulu, C., Yumuk, V., & Yumuk, P. F. (2025) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2025.07.002 · Cited by 8
Tang, J., Dong, Z., Sheng, J., Yang, P., Zhao, W., Xue, J., Li, Q., Lv, L., & Lv, X. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1251662 · Cited by 6
Qi, H., An, Y., Hu, X., Miao, S., & Li, J. (2023) · IEEE Access · doi:10.1109/access.2023.3289403 · Cited by 6
Zhang, Y., Liu, J., Li, F., Cao, F., & Li, A. (2021) · Contrast Media & Molecular Imaging · doi:10.1155/2021/5546030 · Cited by 6
Deng, H., Wang, L., & Li, Y. (2024) · Future Oncology · doi:10.1080/14796694.2024.2402215 · Cited by 5
The Impact of Myosteatosis Percentage on Short-Term Mortality in Patients with Septic Shock
Kim, J., Ha, J., Kim, Y., Ko, Y., Park, T., Kim, K. W., & Kim, W. Y. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11113031 · Cited by 5
Sarcopenia and monocyte-to-lymphocyte ratio as prognostic factors in early-stage breast cancer
Zattarin, E., & Vernieri, C. (2020) · Annals of Translational Medicine · doi:10.21037/atm.2020.03.171 · Cited by 5
Wu, L., Nie, T., Zhi, X., Ouyang, D., Zhang, L., Wu, H., Li, X., Wu, H., Han, P., Chen, L., et al. (2025) · European Radiology · doi:10.1007/s00330-025-12028-8 · Cited by 4
Thormann, M., Heitmann, F., March, C., Pech, M., Hass, P., Surov, A., Damm, R., & Omari, J. (2022) · Journal of Contemporary Brachytherapy · doi:10.5114/jcb.2022.119515 · Cited by 4
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Beypınar, İ., Kaya, F., & Demir, H. (2021) · Akdeniz Medical Journal · doi:10.53394/akd.979541 · Cited by 4
Scoping review: obese elderly women with breast cancer and physical activity/exercise
Felix, M. S. (2022) · Global Health Journal · doi:10.1016/j.glohj.2022.07.011 · Cited by 4
Alexandra, B., Hassani, M., BENONI, A. A. P., Martina, R., Francesca, B., Parlakian, A., Li, Z., Xue, Z., Adamo, S., & Coletti, D. (2017) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12255 · Cited by 7
Harvie, M., Pegington, M., Howell, A., Lim, Y. Y., Livingstone, K., Rose, D., McMullan, D., Maxwell, A., Barrett, E., Sellers, K., et al. (2025) · British Journal of Cancer · doi:10.1038/s41416-025-03129-8 · Cited by 3
Şahin, T. K., & Güven, D. C. (2024) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2024.08.015 · Cited by 3
Lee, S., Yang, Y.-J., Lee, D. W., Song, S. Y., Lew, D., & Yang, E. (2023) · Frontiers in Oncology · doi:10.3389/fonc.2023.1211593 · Cited by 3
Aredes, M., de Paula, N. S. D., & Chaves, G. V. (2024) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2024.112539 · Cited by 2
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Kollár, D., Benedek-Tóth, Z., Drozgyik, A., Molnár, F. T., & Oláh, A. (2021) · Orvosi Hetilap · doi:10.1556/650.2021.31987
Özkan, O., Geçgel, A., Erol, S., Gökmen, E., & Bıçaklı, D. H. (2025) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2025-005991 · Cited by 2
Cebeci, S., Birsin, Z., Jeral, S., Abbasov, H., Aliyev, V., Çerme, E., Çiçek, E., Atak, S., Günaltılı, M., Guliyev, M., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15103736 · Cited by 2
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Caan, B. J., Quesenberry, C. P., & Lee, C. (2018) · JAMA Oncology · doi:10.1001/jamaoncol.2018.5299 · Cited by 2
Navarro-Ibarra, M. J., Saucedo-Tamayo, M. D. S., Alemán-Mateo, H., Parra-Sánchez, H., Othón-Ontiveros, P., Hernández, J., & Caire‐Juvera, G. (2023) · Biological Research For Nursing · doi:10.1177/10998004231207022 · Cited by 2
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Amitani, M., Oba, T., Kitazawa, A., Iji, R., Kiyosawa, N., Katsuyama, S., Morikawa, H., Chino, T., Shimizu, T., Ono, M., et al. (2025) · Breast Cancer Research and Treatment · doi:10.1007/s10549-025-07827-y · Cited by 1
Ferreira, P. D. A., Montalvão-Sousa, T. M., Colombelli, N. L., de Oliveira, B. L., Melo, L. M., Blazevich, A. J., & Lima, R. M. (2025) · Psycho-Oncology · doi:10.1002/pon.70354 · Cited by 1
Chun, S., Lee, H. S., Jung, J.-H., Kim, S. H., Cho, I. Y., Han, K., & Shin, D. W. (2026) · Breast Cancer Research and Treatment · doi:10.1007/s10549-026-07899-4 · Cited by 1
Araújo, R. G., de Moura, R. B. B., de Carvalho, A. G. C., Vaz, L. M. M., de Melo, Â. B. P., & Sampaio, F. C. (2020) · Revista de Pesquisa Cuidado é Fundamental Online · doi:10.9789/2175-5361.rpcfo.v12.9494 · Cited by 1
Calixto‐Lima, L., Wiegert, E. V. M., de Oliveira, L. C., Chaves, G. V., Avesani, C. M., & Bezerra, F. F. (2024) · Nutrition · doi:10.1016/j.nut.2024.112351 · Cited by 1
Goggins, T. F. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-93249-3.00014-x · Cited by 1
Prevalence and presence of sarcopenia and sarcopenic obesity in female breast cancer patients
Kayalı, F. İ., & Habiboğlu, R. (2024) · Clinical Science of Nutrition · doi:10.62210/clinscinutr.2024.81 · Cited by 1
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Chakraborti, S., Ghosh, M., Ghosh, P., Mondal, K., & Chakraborti, T. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-30098-1.00001-x · Cited by 1
Chonaill, D. N., & Ryan, A. M. (2024) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2024.09.024 · Cited by 1
Zhang, F., Yu, Z., Shi, H., & Zhuang, C. (2020) · journal of nutritional oncology · doi:10.34175/jno202001002
Visualizing Frailty: Exploring Radiographical Measures of Frailty in Trauma Patients
Fakunle, O. P., Patel, M., Kravets, V. G., Singer, A. D., Hernandez-Irizarry, R., & Schenker, M. L. (2021) · JOURNAL OF ACUTE CARE SURGERY · doi:10.17479/jacs.2021.11.3.121
Studies on the treatment of bone metastases
Pielkenrood, B. J. (2022) · doi:10.33540/1391
Hanna, P. E., Ouyang, T., Tahir, I., Katz‐Agranov, N., Wang, Q., Mantz, L., Strohbehn, I. A., Moreno, D., Harden, D., Dinulos, J. E., et al. (2023) · medRxiv · doi:10.1101/2023.02.08.23285587
Tang, J., Dong, Z., Yang, L., Yang, P., Zhao, W., Deng, L., Xue, J., Cui, Y., Li, Q., Tang, L., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3380957/v1
Kuş, T., ÇORAPLI, M., Yusufoğlu, B., Aktaş, G., & Oktay, C. (2023) · Acta Medica Alanya · doi:10.30565/medalanya.1167930
Kim, I.-H., Choi, M. H., Lee, I. S., Hong, T. H., & Lee, M. A. (2021) · Figshare · doi:10.6084/m9.figshare.13605524
Mallard, J. (2022) · theses.fr (ABES) · doi:10.70675/f8b2c96bzc4cdz4249z8e59z5f87c7ca2462
Zopf, E. M., Jörnåker, G., Clauss, D., Trevaskis, M., Hiensch, A. E., Schmidt, M. E., Monninkhof, E. M., Zimmer, P., Belloso, J., Heyrman, E., et al. (2026) · Breast Cancer Research · doi:10.1186/s13058-026-02235-6
The relationship between sarcopenia and breast cancer: mechanistic pathways and clinical relevance
Wu, Y., Cao, H., Li, M., Hong, J., Zhou, H., Gao, X., & Song, D. (2026) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2026.1731822
Duan, W., & Wang, R. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1891251
Resuli, B., Tufman, A., Völter, F., Kauffmann-Guerrero, D. E., Mras, P., Arnold, P., Bleistein, C., Behr, J., Vasileva, V., Sundar, L. K. S., et al. (2026) · Cancers · doi:10.3390/cancers18172857
Metadata
- Authors
- Rier, H. N., Jager, A., Sleijfer, S., van Rosmalen, J., Kock, M. C. J. M., & Levin, M.-D.
- Affiliations
- Albert Schweitzer Ziekenhuis (NL)
- Erasmus MC Cancer Institute (NL)
- Erasmus MC (NL)
- Corresponding author
- Rier, Hánah N.
- ORCID
- Venue
- The Breast
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 31
- Pages
- 9-15
- ISSN
- 0960-9776 (ISSN-L)
- OpenAlex
- W2540033076
- Cited by
- 149
- References
- 42
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 20 · 2023: 14 · 2022: 18 · 2021: 25 · 2020: 20 · 2019: 16 · 2018: 16 · 2017: 5
- FWCI
- 9.94
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Breast (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Health Sciences › Medicine › Oncology › Sarcoma Diagnosis and Treatment
- Keywords
- metastatic breast cancer, skeletal muscle index, sarcopenic obesity, low muscle mass, prognostic factors, overall survival, time to next treatment, palliative chemotherapy, skeletal muscle quality, sarcopenia
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Female, Humans, Middle Aged, Muscular Atrophy, Neoplasm Metastasis, Netherlands, Palliative Care, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Prevalence, Muscle, Skeletal
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