Suzanne,
       You asked about breastfeeding before breast cancer surgery.  There is
no reason this mother can't breastfeed before she has her surgery.  (Since you
mentioned "unaffected breast" I'm assuming she's been diagnosed with breast
cancer as opposed to any other type.)  She may want to only breastfeed on the
unaffected side.  This has nothing to do with there being cancer in the other
breast--the baby can't "catch" cancer from that side.  But it is impossible for
the surgeon to remove every tidbit of breast tissue from the chest wall.
Childbirth starts the milk production process and that breast tissue may be
making some milk.  After surgery, there may be some engorgement if that tissue
continues to make some milk, because there is no outlet for the milk.  So she will
probably have less trouble with this if she did not ever put baby to that
breast and stimulate more milk production in that breast.
       This mother can also breastfeed from the unaffected breast until the
chemo starts, if she wishes.  She can then pump and discard the milk that's
produced after chemo starts, to slowly reduce the supply and prevent engorgement.
 Some types of chemo seem to affect milk supply, so depending on what she
gets, she may have less discomfort from continued milk production.  I have known
mothers who breastfed previous children, then were diagnosed during another
pregnancy with breast cancer, who breastfed until chemo started, so that they
could honestly say they had breastfed all their children.
       Lately, I have been finding more mothers willing to pump to maintain
supply during chemo treatment, so that they can try to put baby back to breast
after the chemo is done.  There are conflicting schools of thought about this.
 Many chemo doctors are concerned that the chemo toxins will be stored in the
mother's body tissue and released over long periods of time, so could get to
the baby through the mother's milk.  Others feel that the half-life is
whatever it is for any given drug, and that after an appropriate number of half-life
times have passed, it would be safe for the mother to begin breastfeeding
again.  This is something the mother will need to discuss with her doctor, if she
feels she might have the energy to pump and discard her milk during chemo
treatment.  And some mothers start out planning to pump and maintain supply, but
then find they are just too miserable during chemo and cannot follow through
with the pumping.
       Good luck to this mother.  I hope the treatments work well for her.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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