Most mothers would agree that breastfeeding is one of the most gratifying yet challenging and sacrificial parts of being a mum. On top of battling latch issues, juggling the delicate balance between oversupply and undersupply, and being chained to a breast pump several times a day, mothers often grapple with breastfeeding complications such as sore/damaged nipples, engorgement, clogged ducts and mastitis. Such complications present as nipple changes and/or discharge and breast lumps; which are identical to symptoms of breast cancer. How can you tell the difference? Let’s tackle the myths associated with breastfeeding and breast cancer.
Does developing a lump during breastfeeding mean breast cancer?
Developing breast lumps during lactation is very common and is often non-cancerous. Lumps typically develop due to clogged ducts or mastitis. Clogged ducts occur from blocked milk ducts, which if not cleared, can lead to mastitis (breast inflammation). Mastitis can also be caused by infection. Occasionally, mastitis can be complicated by breast abscess formation (pus collection).
Benign lumps such as cysts (fluid sacs) and solid nodules which are not related to breastfeeding can also form during this time. Rarely, a breast lump which is discovered during breastfeeding is due to breast cancer.
Can breastfeeding women develop breast cancer?
Breast cancer remains the leading cause of cancer among women in Singapore and one in every 13 women will develop breast cancer in their lifetime. One in 6 women diagnosed with breast cancer are below 40 years of age. Cancer may occur in a lady who is breastfeeding though the incidence is low. While breastfeeding has been suggested to lower a woman’s risk of developing breast cancer, performing self-examination regularly after latching or pumping may allow you to recognise any early changes in your breasts.
Can breastfeeding reduce cancer risk?
Yes, it does! Studies have indicated that for every 12 months of breastfeeding, the relative risk of developing cancer is lowered by 4.3%. This is in addition to the 7.0% reduction in risk observed for every birth [1]. The proposed rationale is the hormonal changes that occur during pregnancy and breastfeeding. With breastfeeding delaying the return of our menstrual cycle, our bodies are less exposed to oestrogen. Oestrogen is an important hormone that is produced by our ovaries that assist in puberty, menstrual cycle, reproduction and bone strength. They are present in our male counterparts in smaller amounts. Prolonged excessive exposure has been linked to a possible higher risk of breast cancer development [2].
Mammograms are safe for breastfeeding mothers.
Can breastfeeding mothers undergo mammograms?
Yes, they can! Breast density increases during lactation due to the presence of milk within the breasts, which can obscure findings in mammograms. Lactating mothers are thus encouraged to empty their breasts via direct nursing or pumping prior to their mammograms to improve image clarity and diagnostic accuracy.
Breastfeeding mothers of screening age (40 and above) are advised to continue mammographic screening at regular intervals. Lactating mothers experiencing symptoms which need further investigation may undergo mammograms and/or ultrasound studies based on your doctor’s evaluation. Consult with your doctor to determine the most appropriate option for you [3].
Conclusion
It is normal for your breasts to change in shape and size after pregnancy and childbirth, whether you breastfeed or not. It is crucial for you to understand and pay attention to your body, as a cancer diagnosis and treatment can affect your life as a mother. If you have any concerns or notice anything unusual, please don’t hesitate to schedule an appointment with us for the sake of yourself and your little one.
*Article contributed and reviewed by Dr Lee Wai Peng, Senior Consultant and Breast Surgeon at Solis Breast Care & Surgery Centre, and Dr Sonia Lee, Consultant Radiologist at Luma Women’s Imaging Centre.
References:
[1] Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002 Jul 20;360(9328):187-95. doi: 10.1016/S0140-6736(02)09454-0. PMID: 12133652.
[2] Chen Y, Jiang P, Geng Y. The role of breastfeeding in breast cancer prevention: a literature review. Front Oncol. 2023 Sep 7;13:1257804. doi: 10.3389/fonc.2023.1257804. PMID: 37746260; PMCID: PMC10512942.
[3] Expert Panel on Breast Imaging:; diFlorio-Alexander RM, Slanetz PJ, Moy L, et al. ACR Appropriateness Criteria® Breast Imaging of Pregnant and Lactating Women. J Am Coll Radiol. 2018 Nov;15(11S):S263-S275.
