Catherine,

 

It has been over 4 years since my breast reconstruction but I do not recall
any inflammation.  I had many complications (post-op fever, necrosis of
large areas of the incisions, a seroma that had to be drained 2-3 times a
week for 14 weeks) and I never had any inflammation.  Did this person have
immediate reconstruction or was it done later?  Maybe she had radiation
prior to her reconstruction or mastectomy?  This doesn't sound like a normal
reaction.  My plastic surgeon also told me to avoid the sun for many weeks
after my reconstruction because he had other patients who had problems with
healing after being in the sun (clothed).  Could this be the case?  Did she
have inflammatory breast cancer?  Certainly not a good sign then.

 

A few more comments on breast cancer.I have a client who had a mastectomy a
few years ago and had a nipple sharing reconstruction (part of the
noncancerous breast's nipple was removed and grafted to the reconstructed
breast).  She is 41 years old but did talk to the surgeon about the
possibility of more children and her desire to breastfeed again and was
assured she would be able to.  I've only talked to her on the phone and she
says she has full sensation in the host nipple but it is considerably
smaller than it was before.  Baby would not latch on in the hospital but I
don't think a good effort was made to help her.  She has been pumping and is
getting some milk to feed the baby but wants to continue to try to
breastfeed directly.  Does anyone have any experience working with a mom in
this situation and were they successful?

 

Also I posted here several weeks ago about a mom who was nursing an 8 month
old, 5th nursling, who developed a lump in her breast and decreased milk
supply.  She weaned and the lump decreased some in size but the breast
surgeon refused to aspirate or do a biopsy, just a "wait and see" approach.
Ultrasounds showed no mass but inflammation.  When I saw her she had a lump
the size of an orange and the nipple was distorted and fixed to the chest
with peau d'orange skin under the breast.  It has been more than a month
since I saw her but I have been following her progress by phone.  I
suspected a huge galactocele or possibly inflammatory breast cancer.  I
spoke with her tonight and she finally got a second opinion, saw the surgeon
Monday, had a coil breast MRI (never heard of it-brand new technique)
Tuesday, saw the surgeon again Thursday to discuss the results, and is
finally having a biopsy tomorrow (five different samples) to rule out
inflammatory breast cancer.  I am praying for the galactocele instead.  I'm
very angry that this woman didn't get the prompt treatment that she needed.
This is why so many cases of inflammatory breast cancer are not diagnosed
correctly until it's too late.  This woman was told by the first surgeon
that she wouldn't aspirate because "they'd be there till midnight".  HUH?
What kind of excuse is that?  This woman first noticed a lump in February
and it's now the end of June.  An ultrasound wasn't done until May.  I hope
this is an exception to the care lactating women get when they have a breast
problem and not typical.  Please keep her in your prayers tonight and thank
you to Kathleen and Natalie who confirmed that my gut feeling was right and
not to let this mom be dismissed without proper workup.

 

Linda Anderegg, RNC, IBCLC, RLC in Chicago 


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