Hello Wiseones!

I have permission to post.  I spoke with a pregnant mom today who is expecting her first baby in early-May.  Mom has been diagnosed with a thyroid tumor, follicular with Hurthle cells.  She says there is a roughly 50/50 chance she has a malignancy.  Surgery has been scheduled for 3 weeks after the baby's birth and results of biopsy will take about a week, so baby will be about 4 weeks old before mom knows if her tumor is malignant.  Mother is very committed to give baby as much milk as possible.  We talked about letting baby breastfeed naturally until milk supply is well established, then introducing pumping so mom can store as much milk as possible before biopsy results come back.

Now, if biopsy shows benign tumor, all is well and breastfeeding can continue as normal.  If she has a malignancy, her doctors want her to wean immediately and involute as fast as possible so when she starts I-131 treatment, she will be "dry."  Hale's book says there is a theoretical risk of breast cancer if radioactive iodine is given to a woman currently lactating.  And this is what her oncologists are concerned about.

So, our questions to you all are:

Does anyone know if there is a real risk of breast cancer with I-131 treatment on a lactating woman?  Data?  Is this risk still considered "theoretical"?

If she does decide to maintain milk supply during her I-131 treatments, can the milk be used after radioactive decay occurs, or should she pump and dump?  I see the half-life for I-131 is 8 days. I am reading in my older edition of Hale's that I-131 is potentially high-risk due to long radioactive half-lives and their "affinity for thyroid tissues."

Mom and I talked about lining up donor breastmilk and I gave her resources for safe milk sharing.

Any insight would be greatly appreciated!

Kathleen Salisbury, IBCLC, RLC
Auburn Regional Medical Center
Lactation Services
Auburn, WA, USA



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