Sarcopenia Nearly Doubles Risk Women Will Quit Endocrine Therapy

M. Alexander Otto, PA, MMS

May 17, 2022

The study was published on as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Having sarcopenia almost doubles the risk that women with hormone receptor (HR)–positive breast cancer will stop receiving endocrine therapy early owing to side effects.

Why This Matters

  • It is known that sarcopenia is associated with a reduction in chemotherapy adherence and is predictive of worse survival among patients with early-stage and metastatic breast cancer, but its impact on endocrine therapy has not been well studied.

  • This study suggests that improving or reversing sarcopenia beforehand with, for instance, a supervised exercise program could reduce side effects and increase adherence to endocrine therapy.

Study Design

  • The team assessed the relationship between sarcopenia and side effects from endocrine therapy in a cohort of 482 women with stage I–III breast cancer.

  • Women with a skeletal muscle index below 6.75 kg/m2 were considered to have sarcopenia.

  • Endocrine therapy included tamoxifen (n = 103), aromatase inhibitor therapy (n = 419), and ovarian ablation (n = 23). Some women received multiple therapies.

Key Results

  • More than one third (35%) of women had sarcopenia at baseline.

  • Sarcopenia more than doubled the odds of endocrine-related side effects (odds ratio [OR], 2.31; P = .01) and almost doubled the odds that women would change or stop treatment because of them (OR, 1.94; P = .05).

  • Medical comorbidities and BMI were not associated with endocrine therapy toxicity.


  • The study was retrospective with a homogeneous population (90% White).

  • The timing of the sarcopenia evaluation was not standardized.


  • There was no funding for the work, and the investigators have disclosed no relevant financial relationships.

This is a summary of a preprint research study, "Association of Sarcopenia With Endocrine Therapy Toxicity in Patients With Early Breast Cancer," led by Gabriel Aleixo of the Cleveland Clinic. The study has not been peer reviewed. The full text can be found at

M. Alexander Otto is a physician assistant with a master's degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email:

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.