Dear Harry, Don't you EVER feel like you have to SIT on your hands, and not
CONTRIBUTE. Share on you! : ) We want your contributions. Kathleen A. is
away till Sunday, but I see that she has already responded to this point..
THe story you tell is very very sad. HOly cow. I am 37. : (
I agree with you. Any mother who ever calls me about a lump is always
referred to their doctor for further evaluation. I think that many many
doctors however, do not realize that you cannot get a good picture with a
mammogram on a lactating breast, OR they tell a mom to wean. I think that
Sarah's info is good that you can still lactate after/during an incisional
biopsy.
I like the idea of Lcs teaching breast self exam. Or at the very least ,
stressing the importance of such to all women they work with.
Thanks Harry. Please don't just sit back....we want to HEAR FROM YOU!!! : )
Kathleen
> Gee, I guess it's time to put my two cents in. I've tried to restrain
>myself and just sit on my hands and just be the technician downloading
>Lactnet for my wife Sarah, the IBCLC of the family. But looking over her
>shoulder while she read the material, I felt compelled to elaborate on a
>comment made by Kathleen A.
> Oh yeah, my credentials are that I'm an internal medicine doc who was
>drawn into the study of breastfeeding by my better half. I am a Medical
>Associate with LLL and have researched the literature and spoken on the
>topic of breastfeeding and medications at state LLL conferences. However as
>an internist and not being a Ped or Ob-Gyn, my area of "expertise" is
>limited when it comes to breastfeeding.
> Nonetheless, let me stick my neck out and provide a word of caution
>about the evaluation of palpable breast lumps. Any lump that is felt and a
>*definitive* diagnosis (such as a cyst) can not be made by ultrasound or
>other imaging techniques should be biopsied. An ultrasound or mammogram can
>be "normal", i.e. a mass may not show up on these studies, yet a woman may
>have a breast cancer. The physical examination and imaging studies are
>complementary. Either a palpable mass OR an abnormal imaging study requires
>further evaluation. One or the other can pick up problems missed by the
>other. A very sad example: A dear friend of ours, a 38 yo mother of five,
>nursing her 1+ yo was found by her Gyn to have a lump. A mammogram was done
>and apparently based on this info, the Gyn advised the patient to return in
>6 months for followup after weaning the child. To make a long story short,
>after that 6 month followup, she had definitive surgery last week and has a
>breast cancer with 11 positive lymph nodes. Her prognosis is grim! :(
> The moral of the story: A mass in a lactating breast should never
>cavalierly be blamed on breastfeeding!
> Harry Chaikin, M.D.
> P.S. Sarah wanted me to add that biopsying a lactating breast does not
>preclude continuing nursing.
>
>
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Kathleen B. Bruce RN, BSN, IBCLC
Williston, Vermont USA
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