Becoming a Mother After Breast Cancer

With more and more women choosing to start their families later on in life, they now fall with increasing frequency into the cancer demographic. Worldwide, about 10 – 20% of females under 40 who get breast cancer will do so either during or within one year of being pregnant. The question is, does this startling statistic pose a risk to the ability of these women to carry full-term and breastfeed?

Dr Rayne of the Netcare Breast Care Centre says that although breast cancer is the second most common cancer in women of childbearing age, there is hardly ever a need to terminate a pregnancy because of the disease. She takes us through the signs, diagnosis and management of breast cancer so that those afflicted with this illness can experience the full joy of being a mother and breastfeeding.

The Signs

“The signs of breast cancer in females who are pregnant are the same as those in women who are not with child. The only cause for concern is that the breast changes so much during pregnancy and lactation that it is difficult to know what is normal and abnormal. The trick is to examine your breasts regularly, just like before pregnancy, and if there are any differences to ask your doctor or breast specialist to examine you,” advises Dr Rayne.

She adds that breast cancer in pregnant or breast feeding women most often presents itself as a growing lump, which is not painful, although the swollen surrounding breast tissue can make it feel sore. Another way it can be revealed is as a hot swollen breast and it is important to mention any signs of abnormal swelling or lumps to your gynaecologist as soon as possible.

Breast cancer is no more dangerous during pregnancy or lactation than in non-pregnant women, but it is often missed and found only when it is large in size and late in stage, which can lead to a worse outcome for the mother.


“It is even more important than normal to consult with a breast specialist or an obstetrician used to dealing with women with breast cancer, because there are so many normal changes occurring in the breast it is difficult to know the difference. The next step is to get a specialist breast radiologist to do an ultrasound scan.”

“Although mammograms are good for looking at breasts normally, in lactational women all that hardworking tissue can be too dense to see through well, and may result in any problems remaining undetected. In addition, the radiation of a mammogram in pregnancy is not good for the baby,” says Dr Rayne.

The Risks and Treatment

Dr Rayne sets our minds at ease by saying, “There is no trimester of pregnancy that the best, internationally validated treatments cannot be given to ensure maximal benefit and survival for you and your baby. While a woman may choose this as the best option, which sometimes is the case, no woman ever has to choose between protecting herself and her child.”

According to Dr Rayne, a new study this year, looking at children up to 18 years whose mothers had had chemotherapy while they were in utero, confirmed that chemotherapy does not harm the foetus if given after the first trimester.

“Surgery can be planned in any trimester, using careful co-ordination between the obstetrician and the breast surgeon, and often breast saving surgery can be offered if that’s what the mother wants. The key to the successful treatment is good multi-disciplinary care shared between the breast specialist, obstetrician, oncologist, radiologist and pathologist. It is also a good idea to involve a psychologist, the family, as well as any other social support to ensure the patient gets the very best care,” adds Dr Rayne.

Breastfeeding after Diagnosis and Treatment

While breastfeeding after a double mastectomy is obviously not possible, mothers who have undergone surgery or a single mastectomy can still give their babies the very best start in life by breastfeeding.

It may help to get an early start by readying yourself to breastfeed when you are still pregnant. As soon as you witness milk coming out of the good breast pumping will stimulate growth areas that may have been compromised during surgery and can build your confidence. This also establishes a good breastfeeding and expressing routine for when your baby arrives.

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A Guide to Successfully Expressing Milk

There is a definite art to expressing milk and Dr Rayne shares the following advice with mothers wishing to express milk effectively:

 Always wash your hands thoroughly prior to expressing

 Express milk in a familiar and comfortable setting without distractions. Choose a time when you are not rushed and won’t be interrupted. A warm place with a comfortable chair is also recommended as a relaxed atmosphere will help the mother to relax so that the milk flows

 Apply heat to the breast first and follow with a gentle massage. Warmth encourages milk flow, so put a warm water bottle or wheat bag to the breast as this will speed-up the process

The Miracle of Motherhood

While a diagnosis of breast cancer may come as a shock, it needn’t diminish the miracle of becoming a mother. “Breastfeeding is an intrinsic and magical part of bonding with your baby and you can still enjoy this process, and give your little one the very best start in life after diagnosis and treatment,” concludes Dr Rayne.

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