Leslie -

I worked tangentially w/ a mom who worked diligently and intelligently to
preserve both breastfeeding and her life, and did both very well.  She'd
have done even better with the breastfeeding had we had one little (and
critical) piece of information:  that (as I understand it now) there is no
need to wean to take chemo.  This is a pretty new idea, and well worth
confirming w/ Drs Lawrence and Hale, but I believe the chemo drugs last in
the body only a few days with each round of chemo.  Weaning during those
few days is necessary, yes.  But then there are several weeks before the
next round of chemo, and during those weeks, there is nothing to
contraindicate breastfeeding.

Weaning during radiation treatment is also not necessary.  The milk supply
of an irradiated breast may dwindle, and milk on that side with subsequent
babies may be limited.

Weaning is not necessary if a lumpectomy is performed, as far as I know;
our local woman had a "wide excision biopsy" - sort of the same thing - and
continued to nurse, although the incision drained for several weeks
afterwards.  If the mom preferred, she could wean from the cancerous breast
and continue to nurse on the other.  And if she has a mastectomy, then of
course she'd be nursing on one side only.

The woman I know also had eggs harvested before she began chemo, since she
was told the chemo might render her infertile.  And she minimized chemo
side effects w/ acupuncture - even got her periods back, which they had
said wasn't likely.

She worked w/ a team of doctors in various places, weighing their opinions
and tailoring a treatment program to fit her situation.  For instance, they
were planning to do chemo, then radiation.  She asked if it would be
possible to do them in reverse order, to increase the length of time she'd
have to nurse her baby.  She pumped while she was doing radiation, to store
milk for the time when she  had to (we thought) wean.

She was advised at every turn to put her life first, since breastfeeding
wasn't as important in the great scheme of things.  But the reality seems
to be that it's very possible to have both.  She was advised that nursing
during radiation would be "too demanding".  I think a lot of advice she was
given was given to try to "protect" her, rather than offering her a
realistic, objective view of what would happen, when, and why, and leaving
it to her to see what she could and couldn't manage at each stage.

Good luck to this mom.  There is very definitely light at the end of the
tunnel.  Someone *please* set me straight if I have any of this information
wrong!

Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY