Sarcopenia is a geriatric syndrome characterized by losses of quantity and quality of
skeletal muscle, which is associated with negative outcomes in older adults and in cancer patients.
Different definitions of sarcopenia have been used, with quantitative data more frequently used in
oncology, while functional measures have been advocated in the geriatric literature. Little is known
about the correlation between frailty status as assessed by comprehensive geriatric assessment (CGA)
and sarcopenia in cancer patients. We retrospectively analyzed data from 96 older women with
early breast cancer who underwent CGAs and Dual X-ray Absorptiometry (DXA) scans for muscle
mass assessment before cancer treatment at a single cancer center from 2016 to 2019 to explore the
correlation between frailty status as assessed by CGA and sarcopenia using different definitions.
Based on the results of the CGA, 35 patients (36.5%) were defined as frail. Using DXA Appendicular
Skeletal Mass (ASM) or the Skeletal Muscle Index (SMI=ASM/heightˆ2), 41 patients were found
to be sarcopenic (42.7%), with no significant difference in prevalence between frail and nonfrail
subjects. Using the European Working Group on Sarcopenia in Older People (EWGSOP2) definition
of sarcopenia (where both muscle function and mass are required), 58 patients were classified
as “probably” sarcopenic; among these, 25 were sarcopenic and 17 “severely” sarcopenic. Only
13 patients satisfied both the requirements for being defined as sarcopenic and frail. Grade 3-4
treatment-related toxicities (according to Common Terminology Criteria for Adverse Events) were
more common in sarcopenic and frail sarcopenic patients. Our data support the use of a definition of
sarcopenia that includes both quantitative and functional data in order to identify frail patients who
need tailored treatment.