Will I be able to breastfeed after having a lumpectomy?

It's been one year since I underwent lumpectomy and radiation for breast cancer. I'm now pregnant (my first) and would like to breastfeed. What do you think?

Congratulations! I would first like to reassure you that you are not alone. In fact, one fourth of women who are diagnosed with breast cancer are premenopausal and up to a third of these women become pregnant after treatment. More and more women are delaying pregnancy until later in life, an age when breast cancer is more common. And with improved surveillance we are detecting breast cancer at an earlier stage, when it can be treated with less radical surgery.

Two main factors will affect your ability to nurse. To begin with, the location of the lumpectomy is important. A lumpectomy performed in the periphery, or outer region, of the breast is less likely to disrupt the ductal system which carries the milk to the nipple. The second factor is the extent of radiation therapy -- this tends to have a greater impact on breastfeeding. Radiation generally involves the entire breast and often produces scarring in the lobules of the breast, where milk production occurs.

It's best to have a wait-and-see approach. Initially your breasts may become very engorged when the milk first comes in. This can be painful, especially in the region of your breast surgery. The volume of milk produced by your involved breast may be significantly less than that produced by the normal breast. Some women find that the normal breast is able to compensate for the demands of the baby, while others need to supplement with formula.

Women who need further radiation or chemotherapy after pregnancy should not breastfeed. There also is no evidence that you can give your baby cancer by breastfeeding, even on the involved side.

There are many rewards of breastfeeding for both mother and baby. The only drawback that I can see in your case is that it is more difficult to detect breast lumps while you are nursing. The breast tissue remains full and somewhat engorged as long as you continue breast feeding, and for up to three months after weaning. For this reason, it's a good idea to have a breast exam with your physician every few months while breastfeeding.

Good luck and stay healthy!

Labels: Breastfeeding, Pregnancy health