Nursing After a Breast Biopsy
By Karen Groh
Sioux City IA USA
From: NEW BEGINNINGS, Vol. 14 No. 1, January-February 1997, p. 20
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time
When a mammogram showed calcifications in my left breast, I was terrified. My fourth child, Micah, then 11 months old, ate only a few finger foods and depended mostly on my milk for nutrition. I didn't want to wean him, but I did not want to risk my own health either. With careful planning, determination, and a supportive surgeon, I learned I could continue nursing Micah and have a biopsy, which would help my physician to clarify my problem.
First, I asked my family doctor, who is very supportive of nursing, to suggest a surgeon. She recommended one and called him to explain my situation and to stress how important it was for me to continue nursing. Since he seemed open to working with me, I made an appointment.
I planned my first visit carefully. I wanted this doctor to see me as a competent, knowledgeable person, capable of working with him to make the best decisions for surgery. I called my good friend and La Leche League Leader, Rosie, for help. Rosie and a Professional Liaison Leader helped me find information about breastfeeding after a breast biopsy, and I took several research articles and a book with me to my first appointment. I also dressed up a little more than usual, and requested that I talk to the doctor fully dressed before I undressed for the exam. In this way, we could hold a discussion while I felt comfortable and less vulnerable.
After the doctor entered the room, we discussed the biopsy in a general way. Then I told him that I was still nursing my 11-month-old son and wished to continue to do so. He suggested that I postpone the surgery until the baby was weaned. I said that weaning might not occur for some time, so I didn't think this was a good option. I explained how important nursing was to us and that although the biopsy was necessary, I wanted to continue breastfeeding.
Using my research articles, we discussed how the biopsy could be done to allow this. First, I requested that the incision be a radial incision, pointing toward the nipple, rather than a circumareolar incision, going around the areola. This ensured that the nerves serving the areola would not be cut. I suggested that we schedule surgery for late morning so that I could nurse all morning. I also asked that we keep medication to a minimum so the amount in my milk would be minimized. For instance, I asked that I not be given a tranquilizer before surgery. I shared with him a research article stating that it was possible to breastfeed after general anesthesia. The doctor was open to all these suggestions, but seemed a little nervous about my nursing on the biopsied side within the first 24 hours after surgery. I explained that if I didn't nurse on that side, the milk would stay in that breast causing it to become engorged, possibly leading to a breast infection. The doctor said that since I was so determined, I could try it, but that it might be very painful. After I saw how open-minded and helpful the doctor was, I felt things would go well.
On the morning of surgery I nursed Micah as frequently as he would take the breast. At 11:00 AM we went to the hospital. Micah stayed home with his father while Rose came to the hospital with me for emotional support. The surgery went well, and soon I was in recovery. My husband and Micah joined me there at 3:00 PM. I offered Micah the right breast and he nursed a little, but was soon distracted by the unfamiliar surroundings. The real test came when we got home that evening. He became hungry and asked to nurse. With a lot of fear, I offered him the left breast, the side that had been biopsied. I positioned him very carefully so that he would not pull on the breast when he nursed. I was ready to do deep breathing to distract myself if it was too painful. What a surprise! It didn't hurt at all! Micah nursed hungrily with no problems.
I was so relieved when the results of the biopsy showed no cancer. Micah is two years old now and still an enthusiastic nurser. I am so glad I didn't allow the necessity of a biopsy to end our nursing relationship. With careful planning, determination, and La Leche League's help, we were able to get through this difficult time and continue our beautiful breastfeeding relationship.
Editor's note: LLLI's Center for Breastfeeding Information has had contact with many Leaders and members who have discovered microcalcifications through mammograms. For some women who have breastfed, this may be a normal phenomenon when microcalcifications are scattered throughout breast tissue. Health care providers may have greater concerns when microcalcifications are present in clusters. (See references 2 and 3.) LLLI encourages anyone with concerns over the results of mammograms to have their questions answered by qualified health care providers, preferably those who are familiar with the lactating breast. Karen Groh was able to have her needs met through thoughtful preparation with a flexible physician.
Love, S. Dr. Susan Love's Breast Book. Addison-Wesley, Reading, Massachusetts, 1995.
Sickles, E., MD. Breast calcifications: mammographic evaluation. Radiology 86-6, 160:289-93.
Thomas, D. et al. Mammographic calcifications and risk of subsequent breast cancer. J Nat Cancer Inst 93-2-3, 85(3):230-34.