~ If you are breastfeeding and scheduled for a breast biopsy, you could participate in a groundbreaking research study. Tanya at the Motherwear Breastfeeding Blog explains how “when you make milk, cells from your milk ducts are exfoliated off in the process. These are called epithelial cells, and they’re detectable in your milk. Past research has demonstrated that long before we notice a lump, those epithelial cells start changing in ways that are precursors to the development of breast cancer.” If you participate in the study at no cost to you, your milk sample could help in the development of a non-invasive means of determining breast cancer risk through breast milk.

~ The Health and Wellness Channel here at b5media features its own blog dedicated to breast cancer awareness written by Karen Lynch. To celebrate BCAM, Karen is running a prize giveaway every day this month! Check out Pink Ribbon Review for your chance to win!

~ Boob Maternity and Nursing sells a “Boob Think Pink” nursing top for CDN $65 at Milkface.com. Three Euros from the sale of each tee goes toward breast cancer research.

~ Breastfeeding 1-2-3 features several articles on breastfeeding and breast cancer:

~ Leaking Breast Milk after Surgery for Breast Abscess or Lumpectomy
~ Breast Self-Exams in Lactating Women
~ Video Demonstration of Breast Self-Exam
~ Promising Anti-Cancer Powers of Breast Milk
~ Breast Cancer Testing: X-rays, Mammograms, Ultrasounds, Cat Scans
~ Breastfeeding after Chemotherapy, Radiation and Lumpectomy
~ Breastfeeding Reduces Cancer Risk
~ One-Sided Nursing with Full Supply

Post from: Breastfeeding 1-2-3

I am walking in support of every woman I know, and in memory of a friend who was younger than I am now when she was first diagnosed with breast cancer. She found her second recurrence herself (which her doctors first told her was just scar tissue) when she was pregnant with her second son. They waited until 6 weeks before his due date so the baby was healthy enough to induce labor so she could start chemotherapy again. I watched her endure another battle with chemo with a toddler and a newborn baby, always with strength and dignity, providing as “normal” an environment as possible for her family. We lost her at age 38, brilliant, beautiful and strong until the very end. Stacey was my mentor and friend, and I miss her terribly.

You can help fight breast cancer too by making a donation to benefit the Susan G. Komen for the Cure and National Philanthropic Trust. Click here to donate. I’ll be sure to let you know how much Jill raises and how the walk goes!

Once you make your donation, you might be interested in reading these articles on breastfeeding and breast cancer:

Leaking Breast Milk after Surgery for Lumpectomy
Breast Self-Exams in Lactating Women
Video Demonstration of Breast Self-Exam
Promising Anti-Cancer Powers of Breast Milk
Breast Cancer Testing: X-rays, Mammograms, Ultrasounds, Cat Scans
Breastfeeding after Chemotherapy, Radiation and Lumpectomy
Breastfeeding Reduces Cancer Risk
One-Sided Nursing with Full Supply

Post from: Breastfeeding 1-2-3

While there are many resources online for dealing with breastfeeding initiated after surgery, it is much more difficult to find anything on healing from a lumpectomy or surgery for a breast abscess on a lactating breast. Consultation of several sources of information revealed that there are many options — good ones — for the breastfeeding mother. Armed with information, a mother in this situation can talk to her medical providers for advice and make the best decision for her.

Here is my understanding about healing after surgery on a lactating breast:

1. Continued breastfeeding can be beneficial because it helps prevent engorgement and mastitis (breast infection). By contrast, binding the breast risks complicating the healing with a breast infection.

2. If milk ducts are cut during the surgery, leaking is to be expected.

3. Breast milk has antimicrobial and healing properties that actually can help the wound heal. The leaking breast milk can help keep the area clean and avoid infections common to open wounds.

4. In the case of leaking breast milk, healing takes place from the inside out (rather than from stitches or glue sealing the wound). It helps to understand that healing takes considerably longer (weeks, not days) but that it can happen and not to worry.

5. Gauze can be used to dress the incision. Replace the gauze as needed to keep the area relatively dry (which means replacing it after every feeding, and potentially multiple times in between feedings as necessary). Try to tape the dressing on consistently so that the sides and edges of the wound stay in the same proximity.

6. Consider whether a low-dose prophylactic antibiotic would be helpful. Factors might depend on worry over infection, the mother’s tolerance for antibiotics, and the mother’s tendency to develop thrush (a yeast infection). If the mother does take antibiotics, she should consider taking probiotics/acidophilus/eating yogurt with live cultures to replenish the good bacteria that can keep her from developing thrush.

7. The mother could cut back to nursing just a few times a day on the affected side (say, morning, noon, and before bed) and that will cut back on the milk flow. It would still be necessary to dress the leaking wound with gauze. Once the wound heals, the mother could try to nurse fully again on that side, keeping in mind that it will take a while for the supply to build back up.

8. One-sided nursing is possible. The mother would need to cut back on nursing on the affected side (slowly, so that she does not develop engorgement or mastitis) and nurse considerably more often on the other side (at least twice as often in the beginning), being sure to watch the baby’s urine and stool output and weight gain, to make sure the baby is getting enough milk. Again she could try to re-lactate on that side once the wound heals. One-sided nursing can result in lopsidedness, which may or may not be bothersome. One solution is to use a mastectomy breast prosthesis when it matters.

9. Weaning completely is also an option. Again the mother would want to do so in a manner that limits her risk of breast infection.

Sources for further reading:

1. The Breastfeeding Answer Book, p. 507 on healing after surgery for a breast abscess.

2. Surgery and the Breastfeeding Mother, from Lactation Education Resources.

3. The following discussions, opinions, and personal stories on the breastfeeding professionals’ email listserv Lactnet: one, two, three, and four.

Post from: Breastfeeding 1-2-3

“Although there are a few studies that report a decrease in the risk of breast cancer after only three or more months of breast-feeding, the evidence for risk reduction becomes more consistent the longer women breast-feed. The most consistent evidence of a relationship between breast-feeding and the risk of breast cancer has been reported in studies of Chinese women who breast-fed for long periods of time. In these studies, women who breast-fed for a total of six years or more (all children combined) over the course of their lives had as much as a 63% decrease in breast cancer incidence compared to women who never breast-fed.”

For more information on breast health and breast cancer, see these articles:

Breast Self-Exams in Lactating Women
Video Demonstration of Breast Self-Exam
Promising Anti-Cancer Powers of Breast Milk
Breast Cancer Testing: X-rays, Mammograms, Ultrasounds, Cat Scans
Breastfeeding after Chemotherapy, Radiation and Lumpectomy
Breastfeeding Reduces Cancer Risk
One-Sided Nursing with Full Supply

Post from: Breastfeeding 1-2-3

VideoJug: How to Become Breast Self Aware

Should you and your doctor decide further testing is necessary, see X-Rays and Mammograms for Lactating Women.

Post from: Breastfeeding 1-2-3

When 26-year-old Paula was diagnosed with stage 1, intraductal breast cancer, she opted for a single mastectomy and reconstructive surgery. She went on to get married and have two children, each of whom she was able to breastfeed exclusively for several months!

At first she wondered how it would feel to be different from the other mothers because she was feeding her baby on one breast. But it soon felt natural, and she recalls, “Sometimes I’d see mothers who nursed from both breasts flip-flopping their babies back and forth and I’d think, what a pain!”

You can read more of the Motherwear Breastfeeding Blog interview with Paula here.

Post from: Breastfeeding 1-2-3

1. X-rays. The radiation used in an x-ray does not affect breast milk and the mother may continue nursing uninterrupted after an x-ray.

2. Mammograms. Mammograms are x-rays of the breast and thus are also safe. However, mammograms are not the most effective tool for screening the breasts of lactating women. Lactating women have dense breast tissue which makes it harder to obtain clear images of the breast. As with a breast self-exam, a woman should nurse or express immediately before a mammogram to drain the breasts as much as possible. Breastfeeding women should consult a mammographer experienced in reading mammograms of lactating breasts, and/or consider other diagnostic tests such as ultrasound.

3. Ultrasound. Ultrasound is safe and compatible with continued breastfeeding. Ultrasounds are more effective than mammograms in determining solid breast lumps as opposed to galactoceles (milk cysts) and abscesses, and can also identify breast implant leaks.

4. CAT scans and MRIs. Even when a test requires the use of a radiocontrast dye, a mother need not interrupt nursing. While the packaging inserts for contrast agents may recommend that a mother refrain from breastfeeding for 24 hours, research shows that this simply is not necessary.

5. Fine needle aspiration. While surgery may be required to determine the nature of a breast lump, sometimes fine needle aspiration can be used to identify a benign cyst or galactocele. The test is relatively painless (one woman described it as similar to a blood draw) and breastfeeding can continue as usual.

6. Biopsy. When a biopsy is necessary, it’s important that a mother choose a surgeon experienced in operating on a lactating breast in order to minimize the cutting of milk ducts. As with lumpectomy and mastectomy, breastfeeding can continue after this breast surgery.

Post from: Breastfeeding 1-2-3

After breast cancer treatment, there is no evidence that breastfeeding increases the risk of breast cancer recurrence, nor that it carries any health risk to the newborn. Women previously treated for breast cancer and free of recurrence are allowed to breastfeed their children. Beneficial effects of breastfeeding for the mother and the newborn should lead physicians and midwives to encourage prolonged breastfeeding in their medical practice.

Furthermore, another review states:

A frequently named reason not to nurse is the discouragement by the health care provider. Women treated with breast cancer should be encouraged to breastfeed their children.

Yesterday I raised the question of breast cancer treatment options for women who wish to preserve their ability to breastfeed. Continuing my series for National Breast Cancer Awareness Month, today I take a look at chemotherapy, radiation, lumpectomy and mastectomy. I mention these only as a springboard for discussion with a woman’s oncologist. Naturally the feasibility and risk associated with each option depends on the particular diagnosis. As a starting point, here’s some basic information on chemotherapy, radiation, lumpectomy and mastectomy from a lactation perspective.

1. Chemotherapy. Chemotherapy requires the breastfeeding mother to wean for the duration of the chemotherapy treatments. An oncologist could advise the mother at what point it would be safe to resume breastfeeding. It is possible to test some expressed breast milk to see if all of the harmful agents have cleared from the mother’s system. Even if the course of chemotherapy was lengthy and the mother was unable to keep up her supply, it may be possible for her to re-lactate. Certainly chemotherapy preserves a woman’s ability to breastfeed subsequent children.

2. Radiation. A mother who receives radiation on one breast can continue to nurse uninterrupted on the unaffected side. Once a doctor has deemed it safe to nurse on the affected side, it remains to be seen how much milk that side will produce–some mothers experience a decrease in supply while others maintain adequate supply.

3. Lumpectomy. A nursing mother would be wise to choose a surgeon who has experience operating on a lactating breast, both because the presence of milk can complicate the surgery slightly, and an experienced surgeon can minimize the cutting of major nerves and milk ducts. Nursing can resume immediately after surgery, as soon as the mother is comfortable. Of course, if the surgery affected only one breast, nursing can continue uninterrupted on the other side. Kellymom.com offers several resources on breastfeeding after breast surgery, including lumpectomy and breast reduction.

4. Mastectomy. A mother who undergoes a single mastectomy can continue breastfeeding uninterrupted on the other side. Thanks to the principle of supply and demand, it is possible for a mother to produce enough milk to feed her baby from her remaining breast.

Post from: Breastfeeding 1-2-3

As always, consult your doctor with respect to medical issues. This disclaimer is particularly important with respect to breast health, given both the seriousness of breast cancer and the current debate over the merit of breast self-exams. While traditionally the recommendation has been for monthly breast self-exams starting at age 20, recent studies have questioned whether breast self-exams reduce the number of deaths from breast cancer. Consequently, the American Cancer Society has changed its recommendation to state that breast self-exams are merely an option available to women, and that the exams have benefits as well as limitations.

If a woman chooses to perform a self-exam, it should be performed when her breasts are not tender or swollen. For most women that means the exam should be performed three to seven days after a woman’s menstrual period has ended. For lactating women (who may or may not have a menstrual cycle) it also means that the exam should be performed after a nursing session when the breasts are least full of milk.

While a lump in the breast is the most common sign of breast cancer, it’s important to keep in mind that there are many other potential causes for breast lumps such as fibrocystic changes, trauma or calcifications (making it all the more important to have any breast changes or warning signs evaluated by a doctor). For lactating women, there are two additional potential causes for breast lumps: mastitis or milk cysts. Mastitis is a breast infection that if not treated properly can turn into an abscess. Milk cysts, also known as galactoceles, are sacs filled with milk.

Ultimately the question of whether to perform a breast self-exam is left up to the individual woman. The goal is for a woman to be familiar with how her breasts normally look and feel so that she may seek medical advice upon noticing any changes. 

Post from: Breastfeeding 1-2-3