February 18, 2011
Dear Mayo Clinic:
One year ago I had a lumpectomy, but no cancer was found. I am 25 years old and three months pregnant. Will I have any issues with breast-feeding?
Breast-feeding shouldn't be a problem for you. Except in cases of extensive surgery on both breasts, women who have had a breast procedure can still successfully breast-feed most of the time, without any increased risk of complications. If you're concerned or have questions, though, before your baby is born, talk to your obstetrician or a nurse who specializes in breast-feeding.
In most cases, breast milk is the ideal food for babies. It contains the right balance of nutrients. Breast milk is easier to digest than commercial infant formula and has antibodies that boost your baby's immune system. So breast-feeding is highly recommended for all new mothers.
The breasts are made up of connective tissue that includes a network of milk-gland-containing lobules that can produce milk along with tiny passages (milk ducts) that carry milk to the nipples. To breast-feed effectively, the milk ducts and the nerves in the breast need to work properly. Breast surgery can sometimes damage these ducts and nerves. But the good news for women in your situation is that even if some of the breast nerves and milk ducts are injured — as can occur when you have a lumpectomy — breast-feeding can still happen.
During some procedures, such as breast biopsies and even breast reduction surgery, the surgical method that's used can also help ensure that breast-feeding is an option in the future. Most of the time, unless all the nerves and ducts are injured, women should still be able to breast-feed without having problems associated with breast surgery.
Surgical procedures that injure all the milk ducts and nerves or those that significantly interfere with the nipple can make breast-feeding from that breast difficult or impossible. However, breast-feeding with just one breast can be effective. Women in this situation may need some extra breast-feeding support, though, as feeding with only one breast can sometimes be challenging. But working with a nurse who specializes in breast-feeding issues (preferably, an international board-certified lactation consultant) can help overcome possible barriers to breast-feeding.
You also may find it comforting to know that lumpectomy and other breast operations do not increase your risk of breast-feeding complications, such as milk cysts (galactoceles) or breast inflammation and infection (mastitis). These common conditions are no more frequent in women who have had surgery than they are in other breast-feeding mothers.
Due to your medical history, it is important that you watch closely for any changes in your breasts. If you notice any new lumps, bumps, pain or other unusual changes — during or after pregnancy — see your doctor to have them evaluated as soon as possible.
Fortunately, surgery or other breast procedures rarely make a woman unable to breast-feed. But having questions or concerns is understandable. You may find it helpful to talk with your obstetrician about breast-feeding. Prior to your baby's birth, in addition to talking with an obstetrician or a specially trained nurse, you may want to learn about the resources your medical facility offers for new mothers who are breast-feeding. Most hospitals have lactation consultants on staff who can work with you both during pregnancy and after delivery.
— Shannon Laughlin, M.D., Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn.