Many times mothers wonder whether they can develop breast cancer while breastfeeding their babies. Although this occurs rarely, it can happen.
A breastfeeding mom not infrequently develops lumps or masses within her breast. The majority of these are benign which means they are not cancerous. But it is natural to be concerned about any suspicious lump or abnormality within the breast.
So in case of any doubt, it is better to consult your health care professional who can guide you about the various diagnostic methods and treatment of a lump.
Pregnancy and lactation is a period when a woman’s body undergoes several changes due to the variation in hormonal levels. Due to the effect of these hormones the breasts also undergo various changes. This includes hyperplasia of the breast tissue for the preparation of breast milk secretion.
Read more about Breast Milk Production and Regulation
There can be various causes of breast lumps during breastfeeding. Most of these occur due to increased secretion and resultant accumulation of breast milk.
Common Causes of Breast Lumps During Breastfeeding
Read more about Breast Lumps During Breastfeeding
Read more about Breast Lump: Causes, Diagnosis, and Treatment
It occurs in the initial days of breastfeeding when the breasts start producing a larger quantity of milk resulting in hard, lumpy and painful. breasts.
Inadequate draining of the breast can lead to trapping of the milk within the breast and blocked duct presenting as a painful breast lump.
Accumulated milk within the breast tissue may get infected leading to mastitis. It is also a painful condition.
If engorgement or mastitis is not treated, it may lead to a build-up of infection resulting in the formation of an abscess. An abscess is a cyst filled with pus and bacteria.
These are harmless breast cysts that contain milk. They are usually small and painless.
They are benign tumors (not cancerous) involving the breast. They are firm and move freely within the breast.
It is also a benign tumor of the breast. It is usually seen during the last months of pregnancy and period of lactation. It is a firm, mobile and non-painful mass.
Other benign tumors
These include lipomas, hamartomas, etc
Is It Possible To Get Breast Cancer While Breastfeeding?
Although rare, it is possible to develop breast cancer while breastfeeding.
Incidence of Breast Cancer in Breastfeeding Mothers
Breast cancer is mainly a disease of older women. It is less common in younger women. Women below 40 years of age constitute less than 5 percent of all breast cancer cases.
Similarly, breast cancer in breastfeeding women is rare. Only about 3 percent of all the breast cancer cases occur in breastfeeding mothers. However, breast cancer in young women is more aggressive.
Breastfeeding Actually Reduces the Risk of Breast Cancer
Breastfeeding is known to have a protective effect against several diseases including cancers.
To know more about the benefits of breastfeeding read : Breastfeeding: Benefits, Problems, and Tips for Better Feeding
Pregnancy and breast-feeding decrease the number of menstrual cycles that a woman experiences in her lifetime, thereby reducing her exposure to hormones. Exposure to certain hormones like estrogen is known to increase the risk of certain cancers. In spite of this, breast cancer can occur in women who have in the past or are currently breastfeeding their babies.
In spite of the low risk, any breast lump discovered during pregnancy should be taken seriously and properly investigated.
Causes of Delay in Diagnosis Breast Cancer While Breastfeeding
The most common symptom of breast cancer is the presence of a breast lump. However, breast lump can also occur due to many other reasons during breastfeeding. In fact, noncancerous breast lumps are very common during breastfeeding.
Due to the low incidence of breast cancer during breastfeeding, the treating doctor is less likely to investigate for breast cancer.
Hormonal changes during breastfeeding result in increased density of breast tissue. This makes interpretation of breast ultrasound and mammograms difficult.
When to See a Doctor?
Most cases of breast lump during breastfeeding are not cancerous and can be treated by home remedies or simple treatment consisting of pain-killers and antibiotics. However if the lump does not resolve even after 1 week of treatment, is growing in size, or recurs in the same area after treatment for mastitis, then you must urgently see a doctor.
Characteristic Features of Breast Cancer
- The breast lump is painless and hard inconsistency.
- The lump does not move beneath the skin which means that it is fixed to the overlying skin or underlying structures.
- The lump causes the overlying skin to dimple or to resemble an orange peel.
- There is bloody discharge from the nipple.
- The nipple becomes inverted.
- There is an itchy or sore rash on the nipple which does not heal.
Diagnosis of Breast Cancer While Breastfeeding
It uses high-frequency sound waves to view the breast tissue. It is usually the first investigation to be carried out for any breast lump. It is non-invasive, free of harmful radiations and absolutely safe to be used in lactation.
It is better to empty the breasts before ultrasound so as to improve the quality of the images.
It is the most effective non-invasive test to detect breast cancer. However, during pregnancy and lactation, ultrasound is considered superior to mammography because the hormone-induced changes in breast tissue result in increased density of breast tissue make interpretation difficult. To improve the quality of images and making interpretation easier and reliable, it is advised that the breasts should be empty of milk as much as possible. This can be done manually or with the help of a breast pump.
In this procedure a fine needle is inserted into the lump and some material is aspirated. This material is then spread on a glass slide, stained with appropriate stains and examined under a microscope.
It is a quick, relatively painless, non-invasive, outdoor procedure. Also, the results are available within a few hours. In majority of cases, this investigation is able to differentiate between cancer and non-cancer breast lumps.
If results are inconclusive on FNAC, a biopsy may have to be performed. It is a small surgical procedure carried out under local anesthesia. A small piece of the breast lump is removed (and after a series of steps including processing, fixation, and staining) it is examined under a microscope. It is the best method to confirm whether cancer is present or not. However, the processing and other steps involved make it a lengthy procedure. The results are available in about 3-4 days.
A biopsy can be a core biopsy in which only a tiny amount of breast tissue is removed or it can be excision biopsy (lumpectomy) in which the entire lump is removed.
Can a Woman Breastfeed Her Baby if She Has Breast Cancer?
Once a breastfeeding mother is diagnosed with breast cancer, she is usually advised to stop breast-feeding.
Depending on the mother’s general health and the extent and stage of cancer, the appropriate treatment is decided upon.
Most of the treatment options adversely affect the mother’s milk supply. In addition, they are not safe for the baby. Hence, doctors generally advise mothers to stop breastfeeding before starting cancer treatment. The decision of whether to continue or stop breastfeeding depends on the treatment offered to the patient.
It is better to consult the treating doctor about whether it is safe to continue breastfeeding during a particular treatment.
Receiving a diagnosis of breast cancer can be devastating to the mother especially when she is breastfeeding her little one. However, the mother needs to be treated on priority. The various treatment modalities are
The extent of surgery is mainly determined by the following factors
- size of the lump
- spread of cancer (stage of cancer)
- involvement of lymph nodes
- spread to distant organs (metastasis)
- microscopic type of the tumor (cancer grade)
Read more about Staging of Breast Cancer
Read more about Metastasis or Metastatic Disease
Depending upon the above factors, surgery may involve the removal of the lump (lumpectomy) or the entire breast (mastectomy). If both the breasts are involved by cancer, both breasts need to be removed (double mastectomy).
The extent of the surgery will determine whether or not breastfeeding can be continued. Breastfeeding from the other breast after one-sided mastectomy can have a positive emotional effect on the mother.
In this mode of treatment, medicines are given to the mother to destroy cancer cells within her body.
Chemotherapy may be given prior to surgery to reduce the size of the lump or after surgery to kill any residual tumor cell present in the body.
These medicines usually have many side effects and are very harmful if they enter the baby’s body through breast milk. Hence breastfeeding should be completely stopped by mothers who are undergoing chemotherapy.
It is given after lumpectomy to destroy any residual tumor cell within the breast.
Radiation therapy destroys a significant amount of normal milk-producing breast tissue in addition to the cancerous growth. However, mothers may be able to produce some milk while undergoing radiotherapy. Also, the mother may be able to breastfeed through the unaffected breast.
Breast cancer treatment results in many side effects like pain, fatigue, weakness, nausea, stomach upset, loss of appetite and weight-loss. Besides these, the emotional challenge of dealing with cancer can completely drain a mother. It is better to have someone who can help with childcare so that the mother can have adequate rest.
The mother should surround herself with well-meaning family and friends who can provide her the much needed emotional support. It is a good idea to join some support group (in-person or online) so that the mother can share her concerns and apprehensions and get solutions from people who are going through the same journey.
Although rare, breast cancer can occur while breast-feeding. In case of any doubt or concern, mothers must consult their doctor and should not neglect their health. Early detection and treatment can significantly improve the outcome.
It is also possible to get pregnant and breastfeed after being successfully treated for breast cancer. There is no increased risk of recurrent breast cancer after breastfeeding.
- F Davis. Lactation following primary radiation therapy for carcinoma of the breast. Int J Radiation Oncology 1985; 11:1425.
- S Higgins, B Huffy. Pregnancy and lactation after breast-conserving therapy for early-stage breast cancer. Cancer 1994; 73(8):2175-2180.
- Chang-Claude J, et al. Breastfeeding and breast cancer risk by age 50 among women in Germany. Cancer Causes Control 2000; 11(8):687-95.
- Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries. Lancet 2002; 360(9328):187-95