I had breast cancer in my late twenties before I had the chance to become a mom. Dealing with the cancer was scary, but I fully expected to recover. At the time I remember worrying more about how my life would change after having cancer and undergoing treatment versus the possibility that I might not make it. I wasn’t prepared to accept that outcome.
Fortunately, the cancer was in the early stages and my prognosis was good. I chose to have a lumpectomy and crossed my fingers that the cancer hadn’t spread beyond the breast area. When I awoke in recovery after the lumpectomy the only thing I wanted to know was if there had been any sign of cancer in my lymph nodes. No cancer meant a lot of things, one of which was no chemotherapy. There are numerous reasons to dislike chemo, but I was particularly worried that it might affect my ability to become pregnant in the future. Having a family someday was something I really wanted.
As it turns out, the cancer hadn’t spread so I was surprised when the medical oncologist suggested I have chemotherapy anyway. Because I was young and otherwise healthy she thought my body could handle it and we could be sure we really had gotten all the cancer. I was overwhelmed by the suggestion and ultimately decided against it; a big reason was my fear that it would damage my ovaries and ability to conceive at a later time. I was already set to undergo radiation treatment, but as a compromise to forgoing chemo I agreed to take two medications. One was Tamoxifen and the other Zoladex.
The Tamoxifen’s job is to block cancer cells from growing in the breast. I took one pill daily for 5 years. The Zoladex was a little more complicated. It had to be injected into my belly by a nurse every month for three years and it induced menopause. I know that sounds strange since I already said that I opted out of chemo in order not to diminish my chances of getting pregnant someday. So why take a drug that would cause menopause? The doctors assured me that the medically-induced menopause was only temporary; that once I came off the medication after three years everything would go back to normal. I crossed my fingers that they were right.
Fast forward several years to a time when I was long done with any type of cancer treatment, including all medications, and finally pregnant for the first time. One of my hopes after giving birth was to be able to nurse my baby, but I didn’t know what to expect after having had breast cancer. One fear that ultimately came to pass was that only one breast grew during pregnancy – the non-affected one. The side where I had the lumpectomy remained the same so I didn’t expect to produce any milk there. I worried there wouldn’t be enough milk in the healthy breast to adequately feed my baby. In the end I was able to successfully nurse her for a few months, but I wish there had been more research available on the topic so that I would have felt more informed ahead of time.
Well here I am pregnant again with my second little one and I finally came across an article that I found to be informative for any survivor who wishes to nurse after having had breast cancer and radiation treatment. The article provides an overview of a more in-depth study published in the 4th edition of the Breastfeeding Atlas. The article confirmed some things I had already learned the first time around, but also clued me into a few new facts. The radiated breast is not likely to grow during pregnancy and usually does not produce much milk, if any. The small amount of milk that might be produced in a breast treated by radiation might be less appealing to the baby anyway. I never tried pumping the first time I nursed, but thought it might help me produce milk in the radiated breast if I tried this time around. However, the article described such milk as “looking thicker and somewhat discolored,” as well as tasting different – saltier (Wilson-Clay & Hoover, 2009). Further, the article also indicated that infants seemed to prefer the milk from the unaffected breast anyway. So there you have it, it is not necessary to try nursing from the breast that underwent radiation. And remember, mothers with twins have only one breast per baby anyhow and are able to produce enough milk for both.
Becoming pregnant after surviving breast cancer is a miraculous and joyous event. Of course, there are always concerns that being pregnant might increase the risk of the cancer returning or that breastfeeding might be unsuccessful. But those worries don’t have to stop survivors from having healthy pregnancies, healthy babies, and positive a breastfeeding experience. I hope this article provided was informative and provided some helpful tidbits, but since each of our experiences differ the best thing you can do is consult your doctors, conduct additional research, and see how things go for you and your baby.
Points to Remember:
- The breast that underwent radiation therapy is not likely to grow during pregnancy
- That same breast will either produce no milk or very little
- If milk is produced, it tends to differ in appearance and taste from the milk in the unaffected breast
- Infants in one study preferred milk from the unaffected breast over the radiated breast
- One breast can produce enough milk for one baby
Wilson-Clay, B. & Hoover, K. (October 13, 2009). Breastfeeding following lumpectomy and radiation therapy for breast cancer. Retrieved online: http://www.breastfeedingmaterials.com/ask-barbara-kay/breastfeeding-lumpectomy-radiation.