Breastfeeding and Mammograms

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Mammogram while extended breastfeeding

Aug 2011

Hello, Has anyone gotten a mammogram while doing extended breastfeeding? My 4th child just turned 2 and I'll be 43 next month. I have Kaiser and they don't usually do mammograms while women are lactating. Last year I told them I still wanted the exam anyway due to family history of breast cancer (post menopausal) so they did the exam but due to the extra milk, they could only say they didn't see any evidence of cancer but noted that due to lactation the picture wasn't perfectly clear. They recommend just waiting until breastfeeding is complete. That may be another 12 months or so (my daughter doesn't breastfeed as much as she did when she was younger). I'm a little concerned about going so long without having a thorough exam, although I've heard that extended breastfeeding is generally associated with lower rates of breast cancer. It is a bit of a dilemma. I'd be most grateful for any advice. Thanks! anonymous

Since my mother had breast cancer, I started having mammograms at age 38 at Kaiser Richmond. I was breastfeeding for at least 3 of them. Each time the technician would say that they couldn't do the mammogram because I was lactating, but I would insist since I did not plan on weaning soon. Each time they performed the test without further pushing. Once I found a lump and had a mammogram, sonogram, and core biopsy. It turned out to be nothing but lumpy breast tissue. Good luck with it all. Long-time nurser
I imagine you'll receive many responses about this question, but I thought I would chime in since I follow news/research about breast cancer pretty closely. If doctors are telling you that the mammogram results cannot be deciphered since you are lactating, I definitely do not see the point of exposing yourself to the radiation if they can't read the results. I know it's still controversial, but there is still quite a debate raging as to whether mammograms are helpful or necessary since they do not increase women's survival rates from breast cancer. With that said, each individual woman and her doctor(s) should come up with a plan of action based on your specific situation. The fact that you've had four children and are doing extended breastfeeding is doing *quite a bit* to protect yourself from breast cancer. If you are not doing this already, I highly recommend following and subscribing to Dr. Susan Love's Research Foundation, which includes news and blog posts. She is at the front lines of focusing the spotlight on breast cancer prevention. I know she has posted blogs/articles on breastfeeding and pregnancy, so I would check her archives on that topic. Good luck in finding more information! (And kudos to you on the extended breastfeeding... My almost 4-year-old still nurses and I wouldn't exchange it for anything.) fellow extended breastfeeding mama
Hi- I can tell you about my experience with this and I hope it helps.

I was diagnosed with breast cancer when my son was 2.5 and nursing about 2 times a day. I was under 40 so I didn't have any routine screening at that point. I discovered the lump myself and it was visible on the mammogram that followed the biopsy. I think that after nursing for over a year your breasts aren't as dense and full as they are when you are newly lactating and thus the images are more clear. However, lactation can always confuse things a bit. I think that after 2 years you should get a pretty clear image on a mammogram and if there is anything suspicious that area could be biopsied. I would definitely ask for one.

However, do be prepared for running after possible false positives. When my second baby was about 3 months(my miracle baby!), I was due for my routine every 6 month mammogram. My breast surgeon told me that the images were going to be very confusing and likely look alarming but given my history we should probably go ahead and do them anyway. He was right--they found a suspicious looking area and while he thought it was almost certainly from lactation and recommended watching it for a few months, the radiologist pushed for a biopsy.

You can imagine the horror and stress and fear I went through for a few weeks there. It was absolutely awful. I ended up getting a biopsy on my one lactating breast which could have caused all sorts of problems with nursing (my baby was only 4 months at the time). In the end it was all negative but it was horrible experience.

I think that since your child is over 2 that it would be best to get the mammogram. Your images will likely be straightforward since you've been lactating for over a year. But you are at a higher risk for false positives which would require extra procedures (biopsies, MRI etc) that you may not need and could cause you lots of stress and possibly end your breastfeeding relationship (due to complications from the biopsy itself). Hope that helps. Feel free to email me if you want to talk more. nursing mama

Your choices are: Stop breastfeeding and do the exam sooner; or keep breastfeeding and do it later. No one wants to do a mammogram while breastfeeding b/c your breasts are lumpy and they don't want to radiate the milk. What to do depends on what your concerns are. If you're super- concerned about breast cancer, then stop breastfeeding and do the exam sooner rather than later. Ask them how long after breastfeeding you should do it so you can plan properly. If you really want to keep breastfeeding and you are just nervous about it but don't really think it's a big deal, then wait. Is it harder for you to wait, or is it harder for you to give up breastfeeding? Are you more uncomfortable with uncertainty or more uncomfortable w/ giving up the breastfeeding? You say you have a family history of breast cancer. Maybe you want to do it sooner? Maybe you want to start weaning now? Your child certainly has had good opportunity to breastfeed, so maybe that goes into the decision. My guess is that you're worried about it, otherwise you wouldn't have done the first one already. After 4 kids I'd guess that the breastfeeding will soon be in your distant past. And if it were me, I'd probably quit and do the exam. In my case, I was older, had a history of tumors but no cancer, felt a new one growing, and I ended up waiting till my child was 3. But I had one kid, who was highly fixated on nursing, and I figured my chances were minimal of problems (other than my history of benign tumors and friends who'd had cancer). I did the exam as soon as I could after that. You know the thing they say on the airplanes: get the oxygen on yourself before you assist others. I tell myself that when I need to take care of myself and feel like I'm not giving as much as I feel that I should to my kid. Good luck
Hello! I am not sure if this will be any help for you. But I recently found out about this other method that can be used to detect breast cancer without a mammogram. Its called, thermal mammography. I heard about it through my chiropractor, Dr. Bartlett at the Acorn Wellness Center. There is a women that is offering her services through the center. I wish I could find the link, but I cant...sorry. Here is Acorn Wellness Center's info, I am sure if you call them, they can point you in the right direction. I really hope this helps. Good luck to you!! http://acornwellness.com/ Sincerely, Laura
Sorry for the late reply. I haven't done this myself, but I have read that if a mammogram needs to be done during lactation, you should pump the breasts as empty as possible as close as possible to the test time. I don't know if that is based on research finding better results, or just someone's opinion. R.K.
I was 42 when I gave birth to my daughter. I nursed her for 2 years, then my OBGYN demanded that I stop for 90 days to have an overdue mammogram. I stopped for 90 days, had the mammo, then, to my surprise, she started nursing again and the milk came back. I ended up nursing her until just before the start of first grade. We made a deal that if she could stay in her own room for 30 nights, she would get a reward. The nursing stopped. Claire

Turned away from mammogram because I'm breastfeeding

April 2004

My son is nearly 4, and we've pared down our nursing to once before bed. The last time (a year ago) I went into the Mammogram center at Kaiser Oakland, they turned me away because of breastfeeding. I'm increasingly convinced that the breastfeeding exclusion is really only relevant when the child is actively breastfeeding over the whole day. Has anyone lied to the mammogram folks (experience at Oakland Kaiser esp. welcome!) and just had a mammo while marginally breastfeeding? We'll certainly be weaning within the year, but I just don't see why I should put off my baseline mammo for a very small amount of breastmilk. I can hand-express only a drop. Oh, and I just turned 40. Jennie

I had the same problem, only the mammogram place wouldn't even make an appt with me because I was nursing a toddler (3x/day) and said to wait until 3 mos after I was done nursing. I had spoken to several clinics about this, and apparently it is true that if you are breast feeding a lot, then the milk ducts cloud the mammogram ''picture'', and they can't get an accurate read. My problem was that I had a sore spot in my right breast which I had had repeatedly had checked manually, but really wanted it looked into further, plus I was 46, and hadn't had a mammogram since I was 40 (2 pregnancies/breasfeeding in the meantime). Finally, after doing some research, I found out that I could ask for a sonogram instead, so insisted that my doctor schedule me for a sonogram and he also filled out the mammogram request. Here is the funny part: When I went for the sonogram at the Alta Bates breast center, the technician took the sonogram to the radiologist for a reading, explained the situation, and the radiologist INSISTED that I have a mammogram because of my age, etc! The reading turned out fine. So, perhaps you could do this: insist that you doctor schedule you for both a sonogram and a mammogram (especially if there is an area of concern), and once you're in for the appt I'll bet they can do it.

Wean to have mammogram?

March 2003

At my recent checkup, I mentioned that because of 2 pregnancies and nursing, I have not had a mammogram since I was 40. I am now 46, and had planned to nurse my 10 mo old until HE was ready to wean (I nursed my first child until she was 2). The dr. suggested that I might want to wean at 12 mos so that I can get on with getting a mammogram, since it can take from 6 mos to a year for the breasts to return to normal after nursing. There is no family history of breast cancer that I know of, though the females in my family have tended to die prematurely from other causes. Any of you medical folk out there who have a feeling about whether this is alarmist or reasonable?

If it were me I would not wean before I was ready solely to have a mammogram in 2003 instead of '04 or '05.
a berkeley internist
Why did they want you to have non-lactating breasts to have a mammogram? Kaiser Martinez gave me a mammogram while lactating and never said a word about it (the lump turned out to be a milk cyst). I even told the person who did my mammogram I was worried about leaking on the machine and she said ''so let it leak!''
I kept nursing
I had a routine mammogram about a month after I stopped breastfeeding my second child. This is when my doctor recommended I have it done. The technician (at Alta Bates imaging) asked me when I had stopped breast feeding and didn't seem to have a problem that it had only been a month or so. Bytheway - your breasts never go back to 'normal' after breastfeeding. I also understand that breastfeeding breaks down the breast tissue, making your breasts less dense and the mammograms easier to read.
es
Nursing your baby is far more beneficial to your breast health than having a mammogram, not to mention your baby's health. There is a great deal of controvery as to the benefit of pre- menopausal mammograms anyway, so a wait of a year or two should not make a difference.
Deborah
I thought I would never be able to wean my then 20 month year old daughter who was very passionate about nursing and nursed to sleep each night after a bedtime story in the rocking chair. We took it quite slowly, eliminating a feeding every few days and the before bed feeding was the last to go. I did this by shortening the feeding by a few minutes every night over about a two to three week period. When we got down to about one minute, she was really okay with that (surprisingly to me) and then one night asked to go in her crib after the story before nursing. The next night she wanted to nurse, which I allowed. She nursed for about a minute or two and stopped on her own, asked to go in her crib, and then never nursed again. She is now three and has asked to nurse because she sees her baby sister nursing, but has no idea what to do so puts her mouth on me (somewhere on my body - could be my belly or my arm) for a second and then seems satisfied. Good luck!
Hannah

Getting a mammogram while breastfeeding

May 2003

Hi -- I remember a few months ago some people had written in about how they had gotten a mammogram while breastfeeding. I am scheduled for one next week, and I'm still nursing my baby. I'm wondering whether there is anything you need to think about in terms of the breast milk? Did you pump after the mammogram? Hold off on nursing for certain number of hours? The doctor said there is nothing to worry about or do with respect to the milk, but I thought I would check to see if anyone heard anything that's different. Thanks.

I took no precautions nor changed my routine.