Went to a most excellent conference yesterday on Br Ca/pregnancy &
lactation.  Jennifer Sobol, MD  said lots of interesting stuff, but the
take home message was do not ignore breasts during pg & lactation.  Keep
doing monthly self exams and insist on follow-up for any masses.  Prove
benign OR suspicious, but ACT.  Don't watch and wait.  The reason outcomes
for Br Ca found during pg and lactation are poor is because they are found
so much later!

Br Ca is same rate for pg/lact women as for non pg/lact women.  Stage for
stage outcomes are same.  The problem is the later stage found in pg/lact
women because no one is paying attention.

Dr. Sobel and Susan Kellogg-Spadt, NP went over aspects of breast exam  and
Dr. Sobol reviewed diagnostic tools.  For masses in pg woman she goes 1.
US,  2. fine needle aspiration, 3. mammo for proven malignancy.

She discussed routine mammos for women who are pg and nursing over a long
period of time.  Take baby with you, empty one breast, do study.  Get baby
to nurse again, empty 2nd breast and do mammo on 2nd side.  She says she
has lots of arguments with radiologists about this, but feels she is right
and they are wrong.  Weaning is never an option just to be able to do a
study of a suspicious lump in BF woman!

So the main message is:
Don't ignore your breasts during pg and lactation.
Pg-do monthly exams, bring any lumps to drs attention and insist on
follow-up, not watch & wait.
Lactation, do monthly exams and get routine mammos if you are over 40.
Follow-up any mastitis that does not resolve COMPLETELY.  Investigate any
masses that aren't obvivous plugged ducts.

Sincerely, Pat in SNJ

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