Skip to main content

Advertisement

Log in

The prevalence of frailty among breast cancer patients: a systematic review and meta-analysis

  • Review Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Coexistence of frailty and breast cancer (BC) is related to a higher risk of hospitalization, mortality, and falls. Given the potential reversibility of frailty, investigating its epidemiology in BC is of great importance. However, estimates of the prevalence of frailty in BC patients vary considerably. We synthesized the existing body of literature on the prevalence of frailty among BC patients.

Methods

We searched English databases (Cochrane Library, PubMed, Medline, CINAHL, Embase, Scopus, and Web of Science) and Chinese databases (CNKI, WanFang, CBM, and VIP database) from the inception to April 15, 2021, and collected observational studies about the prevalence of frailty among BC patients. The robustness of the pooled estimates was validated by analysis of different subgroups, meta-regression, and sensitivity. All data were analyzed using Stata 15.1.

Results

In total, 4645 articles were screened and data from 24 studies involving 13,510 subjects were used in the meta-analysis. The prevalence of frailty among BC patients in individual studies varied from 5 to 71%. The pooled prevalence of frailty was 43% (95% confidence intervals (CI): 36% to 50%, I2 = 98.4%, P < 0.05). Subgroup analyses revealed that the therapeutic method, frailty scales, age, frailty stage, regions, publication years, and study quality were associated with the prevalence of frailty among BC patients.

Conclusions

The prevalence of frailty among BC patients was relatively high, and the conditions of BC treatment can increase the risk of frailty. Understanding the effects of frailty on BC, especially in elderly patients, can provide the healthcare personnel with the theoretical basis for patients’ management and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

Not applicable, no person’s data.

References

  1. Althuis MD, Dozier JM, Anderson WF, Devesa SS, Brinton LA (2005) Global trends in breast cancer incidence and mortality 1973–1997. Int J Epidemiol 34(2):405–412. https://doi.org/10.1093/ije/dyh414

    Article  PubMed  Google Scholar 

  2. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, https://doi.org/10.3322/caac.21660. Advance online publication. https://doi.org/10.3322/caac.21660

  3. DeSantis CE, Ma J, Gaudet MM, Newman LA, Miller KD, Goding Sauer A, Jemal A, Siegel RL (2019) Breast cancer statistics, 2019. CA Cancer J Clin 69(6):438–451. https://doi.org/10.3322/caac.21583

    Article  PubMed  Google Scholar 

  4. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27(17):2758–2765. https://doi.org/10.1200/JCO.2008.20.8983

    Article  PubMed  Google Scholar 

  5. Cancer Research UK. Breast cancer incidence (invasive) statistics, 2019. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/incidence-invasive#ref-1. (May 6, 2021)

  6. Sanoff HK, Deal AM, Krishnamurthy J, Torrice C, Dillon P, Sorrentino J, Ibrahim JG, Jolly TA, Williams G, Carey LA, Drobish A, Gordon BB, Alston S, Hurria A, Kleinhans K, Rudolph KL, Sharpless NE, Muss HB (2014) Effect of cytotoxic chemotherapy on markers of molecular age in patients with breast cancer. J Natl Cancer Inst 106(4):dju057. https://doi.org/10.1093/jnci/dju057

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Armenian SH, Gibson CJ, Rockne RC, Ness KK (2019) Premature aging in young cancer survivors. J Natl Cancer Inst 111(3):226–232. https://doi.org/10.1093/jnci/djy229

    Article  PubMed  Google Scholar 

  8. Alfano CM, Peng J, Andridge RR, Lindgren ME, Povoski SP, Lipari AM, Agnese DM, Farrar WB, Yee LD, Carson WE 3rd, Kiecolt-Glaser JK (2017) Inflammatory cytokines and comorbidity development in breast cancer survivors versus noncancer controls: evidence for accelerated aging? J Clin Oncol 35(2):149–156. https://doi.org/10.1200/JCO.2016.67.1883

    Article  PubMed  Google Scholar 

  9. Guida JL, Ahles TA, Belsky D, Campisi J, Cohen HJ, DeGregori J, Fuldner R, Ferrucci L, Gallicchio L, Gavrilov L, Gavrilova N, Green PA, Jhappan C, Kohanski R, Krull K, Mandelblatt J, Ness KK, O'Mara A, Price N, Schrack J … Hurria A (2019) Measuring aging and identifying aging phenotypes in cancer survivors. J Natl Cancer Inst 111(12):1245 1254 https://doi.org/10.1093/jnci/djz136

  10. Ness KK, Wogksch MD (2020) Frailty and aging in cancer survivors. Transl Res 221:65–82. https://doi.org/10.1016/j.trsl.2020.03.013

    Article  PubMed  PubMed Central  Google Scholar 

  11. Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M, Falandry C, Artz A, Brain E, Colloca G, Flamaing J, Karnakis T, Kenis C, Audisio RA, Mohile S, Repetto L, Van Leeuwen B, Milisen K, Hurria A (2014) International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol 32(24):2595–2603. https://doi.org/10.1200/JCO.2013.54.8347

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cohen HJ, Smith D, Sun CL, Tew W, Mohile SG, Owusu C, Klepin HD, Gross CP, Lichtman SM, Gajra A, Filo J, Katheria V, Hurria A, Cancer and Aging Research Group (2016) Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy. Cancer 122(24):3865–3872. https://doi.org/10.1002/cncr.30269

    Article  PubMed  Google Scholar 

  13. Rockwood K, Howlett SE (2018) Fifteen years of progress in understanding frailty and health in aging. BMC Med 16(1):220. https://doi.org/10.1186/s12916-018-1223-3

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kirkhus L, Šaltytė Benth J, Rostoft S, Grønberg BH, Hjermstad MJ, Selbæk G, Wyller TB, Harneshaug M, Jordhøy MS (2017) Geriatric assessment is superior to oncologists’ clinical judgement in identifying frailty. Br J Cancer 117(4):470–477. https://doi.org/10.1038/bjc.2017.202

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Enoka RM, Duchateau J (2016) Translating fatigue to human performance. Med Sci Sports Exerc 48(11):2228–2238. https://doi.org/10.1249/MSS.0000000000000929

    Article  PubMed  PubMed Central  Google Scholar 

  16. Brownstein CG, Rimaud D, Singh B, Fruleux-Santos LA, Sorg M, Micklewright D, Millet GY (2021) French translation and validation of the rating-of-fatigue scale. Sports Med Open 7(1):25. https://doi.org/10.1186/s40798-021-00316-8

    Article  PubMed  PubMed Central  Google Scholar 

  17. Xue QL, Bandeen-Roche K, Varadhan R, Zhou J, Fried LP (2008) Initial manifestations of frailty criteria and the development of frailty phenotype in the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci 63(9):984–990. https://doi.org/10.1093/gerona/63.9.984

    Article  PubMed  Google Scholar 

  18. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research Group (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–M156. https://doi.org/10.1093/gerona/56.3.m146

    Article  CAS  PubMed  Google Scholar 

  19. Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, Fried LP, Guralnik JM, Katz PR, Malmstrom TK, McCarter RJ, Gutierrez Robledo LM, Rockwood K, von Haehling S, Vandewoude MF, Walston J (2013) Frailty consensus: a call to action. J Am Med Dir Assoc 14(6):392–397. https://doi.org/10.1016/j.jamda.2013.03.022

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mandelblatt JS, Cai L, Luta G, Kimmick G, Clapp J, Isaacs C, Pitcher B, Barry W, Winer E, Sugarman S, Hudis C, Muss H, Cohen HJ, Hurria A (2017) Frailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance). Breast Cancer Res Treat 164(1):107–117. https://doi.org/10.1007/s10549-017-4222-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Williams GR, Deal AM, Sanoff HK, Nyrop KA, Guerard EJ, Pergolotti M, Shachar SS, Reeve BB, Bensen JT, Choi SK, Muss HB (2019) Frailty and health-related quality of life in older women with breast cancer. Support Care Cancer 27(7):2693–2698. https://doi.org/10.1007/s00520-018-4558-6

    Article  PubMed  Google Scholar 

  22. Morgan JL, George J, Holmes G, Martin C, Reed M, Ward S, Walters SJ, Cheung KL, Audisio RA, Wyld L, Bridging the Age Gap Trial Management Team (2020) Breast cancer surgery in older women: outcomes of the Bridging Age Gap in Breast Cancer study. Br J Surg 107(11):1468–1479. https://doi.org/10.1002/bjs.11617

    Article  CAS  PubMed  Google Scholar 

  23. Scheepers E, van der Molen LF, van den Bos F, Burgmans JP, van Huis-Tanja LH, Hamaker ME (2021) The G8 frailty screening tool and the decision-making process in older breast cancer patients. Eur J Cancer Care 30(1):e13357. https://doi.org/10.1111/ecc.13357

    Article  Google Scholar 

  24. Hartley P, Adamson J, Cunningham C, Embleton G, Romero-Ortuno R (2017) Clinical frailty and functional trajectories in hospitalized older adults: a retrospective observational study. Geriatr Gerontol Int 17(7):1063–1068. https://doi.org/10.1111/ggi.12827

    Article  PubMed  Google Scholar 

  25. Kua J, Ramason R, Rajamoney G, Chong MS (2016) Which frailty measure is a good predictor of early post-operative complications in elderly hip fracture patients? Arch Orthop Trauma Surg 136(5):639–647. https://doi.org/10.1007/s00402-016-2435-7

    Article  PubMed  Google Scholar 

  26. Fan J, Yu C, Guo Y, Bian Z, Sun Z, Yang L, Chen Y, Du H, Li Z, Lei Y, Sun D, Clarke R, Chen J, Chen Z, Lv J, Li L, China Kadoorie Biobank Collaborative Group (2020) Frailty index and all-cause and cause-specific mortality in Chinese adults: a prospective cohort study. The Lancet. Public health 5(12):e650–e660. https://doi.org/10.1016/S2468-2667(20)30113-4

    Article  PubMed  PubMed Central  Google Scholar 

  27. Magnuson A, Lei L, Gilmore N, Kleckner AS, Lin FV, Ferguson R, Hurria A, Wittink MN, Esparaz BT, Giguere JK, Misleh J, Bautista J, Mohile SG, Janelsins MC (2019) Longitudinal relationship between frailty and cognition in patients 50 years and older with breast cancer. J Am Geriatr Soc 67(5):928–936. https://doi.org/10.1111/jgs.15934

    Article  PubMed  PubMed Central  Google Scholar 

  28. Brouwers B, Hatse S, Dal Lago L, Neven P, Vuylsteke P, Dalmasso B, Debrock G, Van Den Bulck H, Smeets A, Bechter O, Bailur JK, Kenis C, Laenen A, Schöffski P, Pawelec G, Journe F, Ghanem GE, Wildiers H (2016) The impact of adjuvant chemotherapy in older breast cancer patients on clinical and biological aging parameters. Oncotarget 7(21):29977–29988. https://doi.org/10.18632/oncotarget.8796

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hurria A, Soto-Perez-de-Celis E, Allred JB, Cohen HJ, Arsenyan A, Ballman K, Le-Rademacher J, Jatoi A, Filo J, Mandelblatt J, Lafky JM, Kimmick G, Klepin HD, Freedman RA, Burstein H, Gralow J, Wolff AC, Magrinat G, Barginear M, Muss H (2019) Functional decline and resilience in older women receiving adjuvant chemotherapy for breast cancer. J Am Geriatr Soc 67(5):920–927. https://doi.org/10.1111/jgs.15493

    Article  PubMed  Google Scholar 

  30. Kirkhus L, Šaltytė Benth J, Grønberg BH, Hjermstad MJ, Rostoft S, Harneshaug M, Selbæk G, Wyller TB, Jordhøy MS (2019) Frailty identified by geriatric assessment is associated with poor functioning, high symptom burden and increased risk of physical decline in older cancer patients: prospective observational study. Palliat Med 33(3):312–322. https://doi.org/10.1177/0269216319825972

    Article  PubMed  PubMed Central  Google Scholar 

  31. Gilmore N, Kadambi S, Lei L, Loh KP, Mohamed M, Magnuson A, Cole S, Esparaz BT, Giguere JK, Mohile S, Janelsins M (2020) Associations of inflammation with frailty in patients with breast cancer aged 50 and over receiving chemotherapy. J Geriatr Oncol 11(3):423–430. https://doi.org/10.1016/j.jgo.2019.04.001

    Article  PubMed  Google Scholar 

  32. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 10(1), 89. https://doi.org/10.1186/s13643-021-01626-4

  33. Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al (2000) The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute. Available online at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed April 24, 2021)

  34. Rostom A, Dube C, Cranney A, et al.Celiac Disease.Rockville (MD) :Agency for Healthcare Research and Quality (US) ;2004Sep. (Evidence Reports/Technology Assessments, No.104.) Appendix D. Quality assessment forms. http://www.ncbi.nlm.nih.gov/books/NBK35156

  35. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ (Clinical research ed.) 327(7414):557–560. https://doi.org/10.1136/bmj.327.7414.557

    Article  Google Scholar 

  36. Sterne JA, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54(10):1046–1055. https://doi.org/10.1016/s0895-4356(01)00377-8

    Article  CAS  PubMed  Google Scholar 

  37. Hollenberg DC, Menjak IB, Mehta R, Bristow B, Trudeau ME, Gibson L, Neve M, Norris M, Pasetka M, Rice K, McCullock F, Wright FC, Szumacher E (2019) Gait speed vs. VES-13: a pilot study comparing screening tools to determine the need for a comprehensive geriatric assessment in senior women with breast cancer. J Med Imaging Radiat Sci 50(4):551–556. https://doi.org/10.1016/j.jmir.2019.06.053

    Article  PubMed  Google Scholar 

  38. Hamaker ME, Seynaeve C, Wymenga AN, van Tinteren H, Nortier JW, Maartense E, de Graaf H, de Jongh FE, Braun JJ, Los M, Schrama JG, van Leeuwen-Stok AE, de Groot SM, Smorenburg CH (2014) Baseline comprehensive geriatric assessment is associated with toxicity and survival in elderly metastatic breast cancer patients receiving single-agent chemotherapy: results from the OMEGA study of the Dutch breast cancer trialists’ group. Breast (Edinburgh, Scotland) 23(1):81–87. https://doi.org/10.1016/j.breast.2013.11.004

    Article  CAS  Google Scholar 

  39. Domínguez-Alonso JA, Conde-Estévez D, Bosch D, Pi-Figueras M, Tusquets I (2021) Breast cancer, placing drug interactions in the spotlight: is polypharmacy the cause of everything? Clin Transl Oncol 23(1):65–73. https://doi.org/10.1007/s12094-020-02386-8

    Article  CAS  PubMed  Google Scholar 

  40. Mandelblatt, J. S., Small, B. J., Luta, G., Hurria, A., Jim, H., McDonald, B. C., Graham, D., Zhou, X., Clapp, J., Zhai, W., Breen, E., Carroll, J. E., Denduluri, N., Dilawari, A., Extermann, M., Isaacs, C., Jacobsen, P. B., Kobayashi, L. C., Holohan Nudelman, K., Root, J., … Ahles, T. (2018). Cancer-related cognitive outcomes among older breast cancer survivors in the thinking and living with cancer study. Journal of clinical oncology36(32), JCO1800140. Advance online publication. https://doi.org/10.1200/JCO.18.00140

  41. Gironés R, Torregrosa D, Díaz-Beveridge R (2010) Comorbidity, disability and geriatric syndromes in elderly breast cancer survivors. Results of a single-center experience. Crit Rev Oncol Hematol 73(3):236–245. https://doi.org/10.1016/j.critrevonc.2009.08.002

    Article  PubMed  Google Scholar 

  42. Okonji DO, Sinha R, Phillips I, Fatz D, Ring A (2017) Comprehensive geriatric assessment in 326 older women with early breast cancer. Br J Cancer 117(7):925–931. https://doi.org/10.1038/bjc.2017.257

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Mandelblatt, J. S., Zhou, X., Small, B. J., Ahn, J., Zhai, W., Ahles, T., Extermann, M., Graham, D., Jacobsen, P. B., Jim, H., McDonald, B. C., Patel, S., Root, J. C., Saykin, A. J., Cohen, H. J., & Carroll, J. E. (2021). Deficit accumulation frailty trajectories of older breast cancer survivors and Non-cancer controls: the thinking and living with cancer study. Journal of the National Cancer Institute, djab003. Advance online publication. https://doi.org/10.1093/jnci/djab003

  44. Bellieni A, Fusco D, Sanchez AM, Franceschini G, Di Capua B, Allocca E, Di Stasio E, Marazzi F, Tagliaferri L, Masetti R, Bernabei R, Colloca GF (2021) Different impact of definitions of sarcopenia in defining frailty status in a population of older women with early breast cancer. Journal of personalized medicine 11(4):243. https://doi.org/10.3390/jpm11040243

    Article  PubMed  PubMed Central  Google Scholar 

  45. Bennett JA, Winters-Stone KM, Dobek J, Nail LM (2013) Frailty in older breast cancer survivors: age, prevalence, and associated factors. Oncol Nurs Forum 40(3):E126–E134. https://doi.org/10.1188/13.ONF.E126-E134

    Article  PubMed  PubMed Central  Google Scholar 

  46. Guerard EJ, Deal AM, Chang Y, Williams GR, Nyrop KA, Pergolotti M, Muss HB, Sanoff HK, Lund JL (2017) Frailty index developed from a cancer-specific geriatric assessment and the association with mortality among older adults with cancer. Journal of the National Comprehensive Cancer Network : JNCCN 15(7):894–902. https://doi.org/10.6004/jnccn.2017.0122

    Article  PubMed  Google Scholar 

  47. Mandelblatt JS, Clapp JD, Luta G, Faul LA, Tallarico MD, McClendon TD, Whitley JA, Cai L, Ahles TA, Stern RA, Jacobsen PB, Small BJ, Pitcher BN, Dura-Fernandis E, Muss HB, Hurria A, Cohen HJ, Isaacs C (2016) Long-term trajectories of self-reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance). Cancer 122(22):3555–3563. https://doi.org/10.1002/cncr.30208

    Article  PubMed  Google Scholar 

  48. Corona G, Polesel J, Fratino L, Miolo G, Rizzolio F, Crivellari D, Addobbati R, Cervo S, Toffoli G (2014) Metabolomics biomarkers of frailty in elderly breast cancer patients. J Cell Physiol 229(7):898–902. https://doi.org/10.1002/jcp.24520

    Article  CAS  PubMed  Google Scholar 

  49. Aaldriks AA, Giltay EJ, le Cessie S, van der Geest LG, Portielje JE, Tanis BC, Nortier JW, Maartense E (2013) Prognostic value of geriatric assessment in older patients with advanced breast cancer receiving chemotherapy. Breast (Edinburgh, Scotland) 22(5):753–760. https://doi.org/10.1016/j.breast.2013.01.011

    Article  CAS  Google Scholar 

  50. Jauhari Y, Dodwell D, Gannon MR, Horgan K, Clements K, Medina J, Cromwell DA (2021) The influence of age, comorbidity and frailty on treatment with surgery and systemic therapy in older women with operable triple negative breast cancer (TNBC) in England: a population-based cohort study. Eur J Surg Oncol 47(2):251–260. https://doi.org/10.1016/j.ejso.2020.09.022

    Article  PubMed  Google Scholar 

  51. Gilmore N, Mohile S, Lei L, Culakova E, Mohamed M, Magnuson A, Loh KP, Maggiore R, Belcher E, Conlin A, Weiselberg L, Ontko M, Janelsins M (2021) The longitudinal relationship between immune cell profiles and frailty in patients with breast cancer receiving chemotherapy. Breast Cancer Res 23(1):19. https://doi.org/10.1186/s13058-021-01388-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Middelburg JG, Mast ME, de Kroon M, Jobsen JJ, Rozema T, Maas H, Baartman EA, Geijsen D, van der Leest AH, van den Bongard DJ, van Loon J, Budiharto T, Coebergh JW, Aarts MJ, Struikmans H, LPRO (Dutch National Organization for Radiotherapy in the Elderly) (2017) Timed Get Up and Go test and Geriatric 8 scores and the association with (chemo-)radiation therapy noncompliance and acute toxicity in elderly cancer patients. Int J Radiat Oncol Biol Phys 98(4):843–849. https://doi.org/10.1016/j.ijrobp.2017.01.211

    Article  PubMed  Google Scholar 

  53. Speigl L, Grieb A, Janssen N, Hatse S, Brouwers B, Smeets A, Floris G, Bailur JK, Kenis C, Neven P, Wildiers H, Pawelec G, Shipp C (2018) Low levels of intra-tumoural T cells in breast cancer identify clinically frail patients with shorter disease-specific survival. Journal of geriatric oncology 9(6):606–612. https://doi.org/10.1016/j.jgo.2018.03.021

    Article  PubMed  Google Scholar 

  54. Molina-Garrido MJ, Guillen-Ponce C (2011) Comparison of two frailty screening tools in older women with early breast cancer. Crit Rev Oncol Hematol 79(1):51–64. https://doi.org/10.1016/j.critrevonc.2010.06.004

    Article  CAS  PubMed  Google Scholar 

  55. Handforth C, Clegg A, Young C, Simpkins S, Seymour MT, Selby PJ, Young J (2015) The prevalence and outcomes of frailty in older cancer patients: a systematic review. Ann Oncol 26(6):1091–1101. https://doi.org/10.1093/annonc/mdu540

    Article  CAS  PubMed  Google Scholar 

  56. Kojima G, Iliffe S, Walters K (2018) Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing 47(2):193–200. https://doi.org/10.1093/ageing/afx162

    Article  PubMed  Google Scholar 

  57. Ethun CG, Bilen MA, Jani AB, Maithel SK, Ogan K, Master VA (2017) Frailty and cancer: implications for oncology surgery, medical oncology, and radiation oncology. CA Cancer J Clin 67(5):362–377. https://doi.org/10.3322/caac.21406

    Article  PubMed  Google Scholar 

  58. Chang S, Goldstein NE, Dharmarajan KV (2017) Managing an older adult with cancer: considerations for radiation oncologists. Biomed Res Int 2017:1695101. https://doi.org/10.1155/2017/1695101

    Article  PubMed  PubMed Central  Google Scholar 

  59. Buta BJ, Walston JD, Godino JG, Park M, Kalyani RR, Xue QL, Bandeen-Roche K, Varadhan R (2016) Frailty assessment instruments: systematic characterization of the uses and contexts of highly-cited instruments. Ageing Res Rev 26:53–61. https://doi.org/10.1016/j.arr.2015.12.003

    Article  PubMed  Google Scholar 

  60. Di Donato V, Caruso G, Bogani G, Giannini A, D’Oria O, Perniola G, Palaia I, Plotti F, Angioli R, Muzii L, Benedetti Panici P (2021) Preoperative frailty assessment in patients undergoing gynecologic oncology surgery: a systematic review. Gynecol Oncol 161(1):11–19. https://doi.org/10.1016/j.ygyno.2020.12.030

    Article  PubMed  Google Scholar 

  61. Payne CF, Wade A, Kabudula CW, Davies JI, Chang AY, Gomez-Olive FX, Kahn K, Berkman LF, Tollman SM, Salomon JA, Witham MD (2017) Prevalence and correlates of frailty in an older rural African population: findings from the HAALSI cohort study. BMC Geriatr 17(1):293. https://doi.org/10.1186/s12877-017-0694-y

    Article  PubMed  PubMed Central  Google Scholar 

  62. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC (2012) Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 60(8):1487–1492. https://doi.org/10.1111/j.1532-5415.2012.04054.x

    Article  PubMed  Google Scholar 

  63. Majid Z, Welch C, Davies J, Jackson T (2020) Global frailty: the role of ethnicity, migration and socioeconomic factors. Maturitas 139:33–41. https://doi.org/10.1016/j.maturitas.2020.05.010

    Article  PubMed  PubMed Central  Google Scholar 

  64. Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP (2019) Frailty: implications for clinical practice and public health. Lancet (London, England) 394(10206):1365–1375. https://doi.org/10.1016/S0140-6736(19)31786-6

    Article  Google Scholar 

  65. Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M, Tugwell P, Klassen TP (1998) Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet (London, England) 352(9128):609–613. https://doi.org/10.1016/S0140-6736(98)01085-X

    Article  CAS  Google Scholar 

  66. Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135(11):982–989. https://doi.org/10.7326/0003-4819-135-11-200112040-00010

    Article  CAS  PubMed  Google Scholar 

  67. Pugh RJ, Ellison A, Pye K, Subbe CP, Thorpe CM, Lone NI, Clegg A (2018) Feasibility and reliability of frailty assessment in the critically ill: a systematic review. Critical care (London, England) 22(1):49. https://doi.org/10.1186/s13054-018-1953-9

    Article  Google Scholar 

  68. Ng JK, Kwan BC, Chow KM, Cheng PM, Law MC, Pang WF, Leung CB, Li PK, Szeto CC (2016) Frailty in Chinese peritoneal dialysis patients: prevalence and prognostic significance. Kidney Blood Press Res 41(6):736–745. https://doi.org/10.1159/000450563

    Article  PubMed  Google Scholar 

  69. Kong LN, Lyu Q, Yao HY, Yang L, Chen SZ (2021) The prevalence of frailty among community-dwelling older adults with diabetes: a meta-analysis. Int J Nurs Stud 119:103952. https://doi.org/10.1016/j.ijnurstu.2021.103952

    Article  PubMed  Google Scholar 

  70. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

The conception and design of the review: all authors. Literature retrieval: Shurui Wang, Ting Yang. Literature screening: Shurui Wang, Ting Yang, Aomei Shen. Quality assessment: Shurui Wang, Ting Yang, Aomei Shen. Data analysis: Shurui Wang, Wanmin Qiang, Zihan Zhao, Aomei Shen. Writing—original draft: Shurui Wang; writing—review and editing: all authors.

Corresponding author

Correspondence to Wanmin Qiang.

Ethics declarations

Ethics approval

As this is a systematic review reporting on existing data, ethics approval was not required.

Consent to participate

This article does not contain any studies with human participants or animals performed by any of the authors.

Consent for publication

The authors are responsible for the correctness of the statements provided in the manuscript. There was no need to obtain permission from any person for the publication of this review.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, S., Yang, T., Qiang, W. et al. The prevalence of frailty among breast cancer patients: a systematic review and meta-analysis. Support Care Cancer 30, 2993–3006 (2022). https://doi.org/10.1007/s00520-021-06641-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-021-06641-8

Keywords

Navigation