title: Risk of secondary lymphedema in breast cancer survivors is related to serum phospholipid fatty acid desaturation.
abstract: Secondary lymphedema is a common irreversible side effect of breast cancer surgery. We investigated if risk of secondary lymphedema in breast cancer survivors was related to changes in serum phospholipid fatty acid composition.
  
  
  
  Study subjects were voluntarily recruited into the following three groups: breast cancer survivors who had sentinel lymph node biopsy without lymphedema (SLNB), those who had auxillary lymph node dissection without lymphedema (ALND), and those who had ALND with lymphedema (ALND + LE). Body mass index (BMI), serum lipid profiles, bioimpedance data with single-frequency bioimpedance analysis (SFBIA), and serum phospholipid compositions were analyzed and compared among the groups.
  
  
  
  BMI, serum total cholesterol (total-C), and low-density lipoprotein cholesterol (LDL-C) and SFBIA ratios increased only in the ALND + LE. High polyunsaturated fatty acids (PUFAs) and high C20:4 to C18:2 n-6 PUFAs (arachidonic acid [AA]/linoleic acid [LA]) was detected in the ALND and ALND + LE groups compared to SLNB. The ALND + LE group showed increased activity indices for delta 6 desaturase (D6D) and D5D and increased ratio of AA to eicosapentaenoic acid (AA/EPA) compared to the ALND and SLNB groups. Correlation and regression analysis indicated that D6D, D5D, and AA/EPA were associated with SFBIA ratios.
  
  
  
  We demonstrated that breast cancer survivors with lymphedema had elevated total PUFAs, fatty acid desaturase activity indices, and AA/EPA in serum phospholipids. Our findings suggested that desaturation extent of fatty acid composition might be related to the risk of secondary lymphedema in breast cancer survivors.
authors.affiliation: Department of Nursing, College of Nursing, Chung-Ang University, Seoul, South Korea.
authors.forename: Eunjung
authors.initials: E
authors.lastname: Ryu
authors.affiliation: Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, South Korea.
authors.forename: Seung Yun
authors.initials: SY
authors.lastname: Yim
authors.affiliation: Department of Public Health Sciences, BK21PLUS Program in Embodiment:Health-Society Interaction, Graduate School, Korea University, Seoul, 136-701, South Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Do
authors.affiliation: Department of Rehabilitation Medicine, College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam, South Korea.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Lim
authors.affiliation: Department of Rehabilitation Medicine, College of Medicine, Seoul National University Bundang Hospital, Seoul National University, Seongnam, South Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Yang
authors.affiliation: Department of Public Health Sciences, BK21PLUS Program in Embodiment:Health-Society Interaction, Graduate School, Korea University, Seoul, 136-701, South Korea.
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Shin
authors.affiliation: Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, South Korea. leeseungmin@yonsei.ac.kr.
authors.forename: Seung-Min
authors.initials: SM
authors.lastname: Lee
mesh_terms: D000072656:Breast Cancer Lymphedema / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D001943:Breast Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D005227:Fatty Acids / Q000097:blood*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D012306:Risk; D017741:Survivors
chemical_list: D005227:Fatty Acids
keywords: Arachidonic acid; Breast cancer; Desaturase activity index; Polyunsaturated fatty acids; Secondary lymphedema