LivingBreast cancer during breastfeeding: a difficult diagnosis to face

Breast cancer during breastfeeding: a difficult diagnosis to face

Breast cancer is the most common cancer in women in Spain. So far this year, 35,000 new cases have been diagnosed in our country according to the Spanish Association Against Cancer (AECC), and it is estimated that one in eight women will have breast cancer at some point in her life. However, it has a high survival rate: more than 90 percent overcome it or it becomes chronic, achieving a great quality of life.

Although most of the changes that occur in the breast during pregnancy and breastfeeding are benign, breast cancer can and does occur in pregnant women and new mothers who are breastfeeding . It is common: it occurs in approximately one in 3,000 pregnant women or in the first year after childbirth.

In both cases, it is a difficult diagnosis to assimilate when expecting a baby or with a small baby, and the decisions that will have to be made regarding treatment.

Breastfeeding against cancer

Breastfeeding reduces the risk of breast cancer, especially if a woman breastfeeds for more than a year. According to the European Code Against Cancer, this reduction is 4% for every 12 cumulative months.

But although breastfeeding is a protective factor, breast cancer can also occur in women who are breastfeeding their baby.

Detect breast cancer during pregnancy and lactation

Breast cancer originates in the breast tissue, which is made up mainly of breast milk-producing cells and fatty breast tissue.

Due to the changes that occur in the breasts during pregnancy and breastfeeding, it can sometimes be difficult to detect early breast cancer in women. This often means that the diagnosis of breast cancer is delayed , and when it is detected it is found in a more advanced stage, larger in size and more often with lymph node involvement.

During pregnancy . Periodic reviews should be carried out with the gynecologist, and if any alteration is detected in the physical examination of the breast, the necessary diagnostic tests must be carried out without delaying them until after delivery.

During breastfeeding. Frequent self-examinations (once a month with the breasts emptied) should continue to be performed and consultation should be made if any abnormalities are detected. The difficulty that arises is that it is common for lumps, secretions or changes to appear in the breasts during breastfeeding that can scare us.

It is common that while we breastfeed, infections occur in the mammary ducts, -such as infectious mastitis-, which cause pain, redness and inflammation of the breast. Most respond to antibiotic treatment, but the doctor will need to rule out any possibility of inflammatory breast cancer.

This is an aggressive but rare form of breast cancer, which first appears as an area of redness and irritation on the skin rather than a distinct lump. Your doctor may order a skin or tissue biopsy to be sure.

signs of breast cancer

As we say, during lactation, the breast undergoes important changes that can be confused, but it is important to take into account what are the signs of breast cancer that could alert us and we should not ignore:

  • Swelling of the breast or part of it.
  • Skin irritation or pitting.
  • Breast pain.
  • Nipple pain or nipple inversion (not to be confused with having inverted nipples).
  • Redness, scaling, or thickening of the nipple or skin of the breast.
  • Discharge from the nipple other than milk.
  • Lump in the armpits.

Lumps during breastfeeding

One of the signs of breast cancer can be a lump similar to the one that appears when a breast duct is blocked during breastfeeding. If the obstruction does not resolve within 72 hours after taking anti-inflammatories, applying cold and massage, you should see your doctor for a more thorough review.

Can I be tested if I am breastfeeding?

Breast cancer diagnostic tests are compatible with breastfeeding.

  • Breast ultrasound . It can be done during lactation, since it does not emit radiation.
  • Mammography . It can also be done during lactation since the radiation neither stays in the breast nor is excreted in the milk.
  • Magnetic resonance imaging (NMR) . It can be done during lactation, but not during pregnancy.
  • Biopsy. Biopsy involves removing a small part of the suspicious breast lump, using a needle (punch biopsy or core needle biopsy) or by surgically removing the entire lump (excisional biopsy). Biopsies are safe for breastfeeding women.

Can I continue to breastfeed?

It is not necessary to stop breastfeeding when cancer is detected, since tumor cells have not been observed to be transferred to the fetus. However, it will have to be considered in the face of the treatment to be carried out.

It should be withheld if chemotherapy is given because the drugs pass into breast milk and have potentially serious side effects for the nursing infant. However, there are mothers who decide to keep it by discarding the expressed milk while they are receiving treatment and offering it when it is safe.

On the reference website you can check the compatibility of breast cancer treatments with breastfeeding. They explain with scientific evidence in which cases it can continue to occur, and when it is necessary to suppress it or you can choose to interrupt it for a while.

Breastfeeding after breast cancer

After having overcome breast cancer, breastfeeding is possible, if the mother so wishes. If you decide to breastfeed, scientific evidence indicates that it is a safe and recommended practice after completing therapy.

As explained by Gloria Ortega, a specialist in the Breast Unit at MD Anderson Cancer Center Madrid,

“Only in cases in which a bilateral mastectomy (removal of both breasts) is performed by completely removing the breast tissue, the possibility of breastfeeding is eliminated. For those in which conservative surgery is performed, where only part of the breast is removed, breast tissue, the ability to respond to stimuli and therefore to produce milk can be maintained If, in addition, the nipple-areola complex and the retroareolar mammary ducts have not been removed, it would also be possible, from a mechanical point of view, to breastfeed the baby”.

Support for the mother with cancer

Facing a cancer diagnosis while the mother is breastfeeding her baby is a very difficult situation to face. It is normal for fears and doubts to appear regarding the treatment, added to the stress of caring for a baby that must be attended to.

Therefore, it is important that they receive the necessary emotional support, both from their environment -partner, family, friends-, as well as from health professionals, to advise and accompany them in this process.

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