<I recommended reverse pressure softening and she
found that it worked when lying flat on her back. This seems like a rather
rare situation to encounter since most women with breast cancer either are
not breastfeeding or are not able to breastfeed much longer after their
diagnosis. I was curious if any of you have seen this in your practice or
if you have more information about what might cause the milk removal
difficulty - would it be edema due to inflammation of the breast,>

Breast cancer is known to spread through the lymphatic vessels to lymph nodes, so that
lymphatic drainage may be compromised, causing interstitial fluid to fail to 
drain normally, and thus form edema in affected tissues. That's one of the
primary effects of RPS to "pit" edema or at least temporarily move it away from the
tissues being pressed upon.

If edema had been crowding outside the ducts in the nipple-areolar complex to prevent the passage of milk
through the ducts, then I can see how RPS could help temporarily at least, and 
since it worked better lying down, I am assuming her breasts were D cup or beyond,
so lying down used gravity in helping move and keep the edema away from the nipple-areolar
complex temporarily.

Best wishes to this mother during this difficult time.

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC    Dayton OH

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