Meema writes:
But my doctor says the only way to be 100 percent sure is to cut it off and
biopsy it but says I would have to stop breastfeeding. Obviously, I don't
want to do this, and would rather wait. What would you do?"

I can't imagine why the doctor believes that she would have to stop
nursing-- she didn't get a reason from him and can't reach him now.

Any very specific information I can give her?


Lidocaine used as a local anesthetic for a biopsy like this is 1) low dose, 2) not absorbed much systemically and 3) not passed well into milk.  There would be minimal risk to the baby.  Hale rates it an L2 (safer).  "There have been many studies done on the transfer of lidocaine into breast milk.  All conclude that lidocaine transfer to milk is minimal and probably safe to use during breastfeeding."

Following the procedure there would likely be sutures in the area, and you wouldn't want the baby latched on over the sutures, but assuming it's a small lesion, likely it's not going to be a problem a change in nursing position couldn't fix.

I cannot think of any other reason to discontinue BFing b/c of the removal of a small lesion on the breast.  If this woman walked into my office, I would definitely be willing to biopsy it w/o weaning.

And I'd also be curious whether this was an extra nipple!

Spencer (wearing my MD hat at the moment!)

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        E. Spencer Joslin, MD
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