I was going through files today and came across my original notes on
a woman who had inflammatory breast cancer, this is the second mom to
contact me with this horrendous illness while breastfeeding.  The
first had continuous "deep breast pain" and was not diagnosed until
she weaned and she died several months later.  I thought you might
like to be familiar with this case history.

This mom initially called several times with plugged ducts when her
baby was about six weeks old.  This coincided with her return to work
and pumping, separation etc., so we thought it was related to
irregular emptying of the breast.  She was an experienced nursing mom
who was very knowledgable and had access to good resources.  She
tried massaging and changing nursing positions, heat, ice and every
thing else we could think of. The inflammation got worse and she was
treated for mastitis although she did not have a fever or flu-like
symptoms. After 6 or 7 days  and a change in antibiotics, it seemed
possibly worse and definitery not better. The inflammation was
visible as a large area on the upper outer quadrant of the breast
from 8-12 o'clock  She had a fine needle aspiration (18 gauge needle)
for a culture which collected sterile, sero-sanguinous fluid,
("coffee grounds" was written in my notes), The doctor thought she
had an "abcess broken through blood vessels."  I suggested she follow
up with an ultrasound, this showed an area with "irregular edges"-
not consistent with an abcess, so they tried a mammogram.  This
showed an area dense with inflammation and/or milk, the radiologist
said it looked like a lactating breast.  Then they did an ultrasound
of the whole breast and found several other pockets (?) and
recommended a biopsy.  Her care providers initial reaction was to
give it some more time and not rush things since she was so newly
postpartum, but we encouraged him to talk to another knowledgable
physician who recommended immediate biopsy.  She had a biopsy the
following day, was diagnosed with inflammatory breast cancer and
started chemo two days later. After her chemo to stop growth, she
underwent radiation and then a mastectomy.  She has also had a bone
marrow transplant and more chemo.  She is doing well and still
praying that it will not return.  It will be three years this January.
  In working with breastfeeding moms , I think we need to ba aware
that there are situations like this that need quick action and that
we should trust a mother's feelings that something just doesn't seem
right.  Cathy Liles