Hello, Laura.
Generally speaking, it is not necessary to wean to undergo breast
surgery, although the docs tend to prefer it because then they aren't trying to see
what they are doing during surgery through breastmilk leaking through the
incision, and they don't have to worry about the wound getting infected or
healing more slowly due to milk continuing to leak through the incision during
healing. (However, the mothers I have worked with who decided not to wean, did
not experience either infection or longer healing time.)
However, with radiation there is a different story. The breast tissue
is more "activated" during lactation, and radiation zeroes in on more-active
breast tissue. There is concern that if the breast is still lactating during
radiation treatment, that will lessen the chance for the mother to have any
lactation in that breast after any possible future pregnancy. So, knowing
that radiation is planned, it probably would be best for the mom to wean from
the affected breast sooner rather than later, so the tissue has more chance to
stop producing entirely. At a conference a number of years ago, a
radiologist showed a mammogram of a lactating breast: completely white, with
absolutely no way to differentiate what any of the breast tissue was. This
radiologist said that a woman really has to go 6 weeks and preferably 3 months with no
pumping and no nursing, in order to be able to accurately read a mammogram.
So, I am guessing that it takes at least 6 weeks to completely stop
production in the breast so the tissue would be "inactive" or "less active" during
radiation treatment. However, if the mom has 3-4 weeks of no stimulation to the
affected breast, that should surely help lower the activity level of the
breast tissue.
But radiation is only done to the affected breast. And this same
radiologist showed photos of women who had had radiation, and the line between the
treated side (red, like a sunburn) and the untreated side was quite
remarkable. They really can aim that radiation quite specifically. So the unaffected
breast will not receive radiation (usually) and the mother should be able to
continue to provide breastmilk to her babies from that breast.
Dee
Dee Kassing, BS, MLS, IBCLC, RLC
Collinsville, Illinois, in central USA
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