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Subject:
From:
Janet Vandenberg <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 21 Mar 1999 14:51:55 -0500
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This information might be helpful to share with the nurses who were
concerned that breastfeeding would increase the incidence of tumour
recurrance in the untreated breast after unilateral mastectomy.

This is from a full text Medscape article at:
http://www.medscape.com/Medscape/WomensHealth/journal/1997/v02.n10/wh3104.difronzo/wh3104.difronzo.html

Diagnosing and Treating Breast Cancer in the Pregnant Woman

Authors: L. Andrew DiFronzo, MD, & Theodore X. O'Connell,
MD, FACS,

"In patients cured of their disease by primary treatment, pregnancy
should have no effect, since there is no residual tumor to be
stimulated. In women
whose cancer is not eradicated but is estrogen receptor negative,
the tumor cells are not responsive to hormonal stimulation;
therefore, a subsequent pregnancy should have no real effect on the
disease process. Only in women with estrogen receptor-positive
tumors who are not cured of their disease may a subsequent pregnancy
have a potentially detrimental effect.[34]

Although women can be reassured that pregnancy following breast
cancer is not harmful, the chance of future recurrence of the breast
cancer should be addressed before recommending subsequent pregnancy.
The possibility of future metastatic disease may alter an
individual's desire to consider pregnancy. It appears that breast
cancer recurrence is most common within 2 years of initial
treatment. Donegan[35] studied 892 women treated with mastectomy
during a 21-year period and observed that recurrence peaked at 2
years and subsequently dropped to lower levels. Accordingly, the
clinician caring for a woman who is entertaining the idea of
pregnancy following breast cancer should recommend a 2-year waiting
period, to allow for the potential manifestation of distant
metastases. "

Breast cancer during pregnancy and lactation
by Hoover HC
Surgical Clinics of North America 70(5): 1151-1163, 1990.

http://www.meb.uni-bonn.de/cgi-bin/mycite?ExtRef=MEDL/91019801

" There is no evidence to implicate pregnancy or lactation in either

the etiology or the progression of breast cancer."

References for the possibility of reduced supply if remaining breast
was treated with radiation therapy:

 Neifert M, Breastfeeding after breast surgical procedure or breast
cancer.
    NAACOGS Clin Issu Perinat Womens Health Nurs,
    3(4):673-82 1992
    Abstract:
http://www.medscape.com/server-java/MedPage?med90-92+900433+('Neifert,M':AU+and+cancer)

Tralins, A., Lactation after conservative breast surgery combined
with
    radiation therapy. Am J Clin Oncol, 18(1):40-3 1995 Feb
    Abstract:
http://www.medscape.com/server-java/MedPage?med95-97+9960+('Tralins,A':AU+and+cancer)

Higgins S; Haffty BG, Pregnancy and lactation after
breast-conserving
    therapy for early stage breast cancer. Cancer, 73(8):2175-80
1994 Apr 15
    Abstract:
http://www.medscape.com/server-java/MedPage?med93-94+244663+('Higgins,S':AU+and+cancer)

 --
Janet Vandenberg, RN, BScN, IBCLC
Newmarket, Ontario, Canada
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