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Keywords:

  • pregnancy associated breast cancer;
  • breastfeeding;
  • breast cancer;
  • lactation

Paper Presentation

  1. Top of page
  2. Paper Presentation

Background

The diagnosis of breast cancer is devastating and particularly stressful for the lactating mother and her breastfeeding infant. The mother must make treatment decisions that often include having to abruptly stop breastfeeding. Management of breast cancer during lactation requires a multidisciplinary approach with the nurse and/or lactation consultant serving as important team members. Lactating women receiving a diagnosis of breast cancer require immediate referral to breastfeeding experts who are able to provide them with support and accurate information on weaning strategies. This presentation will utilize a case study of a mother's experience of breast cancer during lactation. The nurse and/or lactation consultant's role in identifying and referring suspicious breast lumps/infections will be outlined, and ways to advocate for and support a woman with a diagnosis of breast cancer during lactation will be identified.

Case

Immediately after receiving a diagnosis of breast cancer at a breast center, a 39-year-old mother breastfeeding her 9-month-old infant presented in the Breastfeeding Clinic, looking for weaning support. Her infant was still breastfeeding seven times per day, had started solids, and refused to take a bottle or sippy cup. The lactation consultant worked with this mother to develop an individualized weaning plan. The mother was able to gradually wean over a 2-week period without developing mastitis, a complication that could delay her cancer treatment. In addition, because weaning is often traumatic for the mother/infant dyad, the lactation consultant provided strategies to support the infant during the difficult transition from the breast.

The advanced practice nurse, nurse practitioner and lactation consultants reviewed the current literature on breast cancer diagnosed during lactation at a journal club and developed a pathway for referring women who present in the breastfeeding clinic with suspicious breast lumps and/or breast infections.

Conclusion

  • Only 3% of women develop breast cancer while they are breastfeeding.
  • Because of the aggressive nature of breast cancer in this age group and the breast changes that occur during pregnancy and lactation that make detection more challenging, prompt referral of nonresolving suspicious breast lumps and/or breast infections is imperative.
  • Nurses/lactation consultants caring for women in the postpartum period require an awareness of diagnostic tests to rule out or diagnose breast cancer, implications to breastfeeding, and weaning strategies for lactating women with a breast cancer diagnosis.