SP 8.02 The Longitudinal Relationship Between Handgrip Strength, Malnutrition, and the Systemic Inflammatory Response in Patients with Operable Breast Cancer
Chattarin Pumtako, Donald McMillan, Nida Rattanakrong, An Ngo-Huang, Rhodora Fontillas, Ross DolanAbstract
Introduction
Functional decline in early-stage breast cancer is frequently overlooked due to stable weight and preserved albumin levels. However, subclinical muscle loss and physical deconditioning may occur, driven by systemic inflammation rather than overt malnutrition. The present study aimed to examine the longitudinal relationship between handgrip strength, malnutrition, and systemic inflammatory response of patients with operable breast cancer.
Methods
This retrospective cohort study included 508 women with operable breast cancer undergoing curative surgery. Handgrip strength (HGS), neutrophil-to-lymphocyte ratio (NLR), BMI, albumin, 6-minute walk test (6MWT), 5-time sit-to-stand test (5STS), ECOG, and FACT-B were assessed at baseline, 1, 3, and 6 months. Severe muscle weakness was defined as HGS <16 kg.
Results
During follow-up, BMI and albumin did not change significantly. In contrast, HGS significantly declined over time (median 21.2 to 19.7 kg, p<0.001). An elevated NLR (>5) was significantly associated with severe HGS impairment at all timepoints (p=0.041, 0.016, 0.042), whereas albumin showed no significant relationship with HGS. NLR increased significantly during follow-up (p < 0.001), peaking at 3 months. Quality of life (FACT-B) scores increased over time (p = 0.024). Six-minute walk test (6MWT) distance improved slightly at 1 month (p < 0.001), and five-time sit-to-stand (5STS) also improved modestly (p = 0.014).
Conclusion
The present longitudinal results would indicate that functional decline following curative surgery in operable breast cancer is associated with persistent inflammation and not a consequence of weight loss per se. These results support a shift toward function- and inflammation-focused monitoring as a new standard in survivorship care.