24 yr. old 6 mo. pregnant mom showed up on unit today for evaluation of her  
breasts.  Both breasts are larger than basketballs.  Shiny and  blanched on 
tops of breast.  Right breast had what appeared to be a fluid  filled area at 
8:00 o'clock.  The inner aspect of her right breast had what  appeared to be a 
two inch long thin wound, that had formed a scab over  it.   The whole 
posterior portion underneath her right breast had a  10cm reddened area, painful to 
touch.  Patient stated she has been  on Keflex 500mg everyday for weeks.  No 
fever at present time.   No leaking of milk.  Her normal bra size before 
pregnancy was a 36B.   She now measures a 48 GGG.   The woman is tall and petite and 
in  severe discomfort.  There is no bra that even fits her. I am concerned  
because the doctor hasn't done an ultrasound.  He actually sent her in to  see me 
and told the patient I might have her pump!  WRONG!  I'm not  about to do 
that and put her at risk for preterm labor, not to mention that it  isn't about 
milk production, this is severe edema.  It appears to me  her lymphatic system 
is not working, right?  Her medical history is  uneventful.  She states her 
breasts have been like this for 3 months and  her back is killing her.  I called 
the doctor and suggested the patient  might benefit from a certified massage 
therapist who specializes in lymphedema  treatment, and I found one thru our 
cancer center.  The patient is going to  see her Friday.  I suggested cold, 
green cabbage leaves and ice packs and  tylenol.  I am going to keep in touch 
with this young, single woman  everyday.  I am so concerned that more is not 
being done for her.   Could this be cancer?  Please feel free to email me 
privately or on  lactnet.  Thanks in advance.  Loni Denman, RN ,  IBCLC 

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