Breast Changes While Nursing? Don't Wait to Evaluate!

I breastfed my three babies and with each one had a troublesome plugged duct in the outer quadrant of the left breast. With the first child it even became infected. I nursed a total of almost four years. I began to feel a lump in my breast when my third child was about two. My doctor dismissed it as normal breastfeeding lumpiness. When she weaned I had my first mammogram and was diagnosed with breast cancer. Surgery and chemo seemed to be effective and I am still here seven years later. But I still look back to that persistently plugged duct and wonder if that was the first clue to the intraductal carcinoma. I hope my story helps other women who are in the same situation.

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Your letter perfectly states the importance of not ignoring breast changes during pregnancy and lactation.

Though it is relatively uncommon for a woman to be diagnosed with breast cancer at this time, it still happens, and it is a travesty when her symptoms have been ignored.

Though lactating breasts have a tendency to be lumpy, any changes need to be brought to the immediate attention of your Health Care Provider (HCP). Regular breast self-exams are important for women at all times in their life. Changes to report to your HCP include unusual discharge, a change in the size or shape of your breast, a change in the color or feel of the skin of your breast, areola or nipple, or a lump or thickening in or near your breast, or in the underarm area.

If your Health Care Provider ignores your symptoms just because you are nursing, do not hesitate to seek a second opinion from a breastfeeding-friendly surgeon. It is possible to evaluate a breast mass during lactation. Ultrasound can help to distinguish a solid mass from a cyst or abscess. Mammography (read by a radiologist very familiar with lactating breasts) can be useful in determining the size and the location of a known lump, though it may not show early tissue changes due to the density of the lactating breast. Fine needle aspiration can also be used in the nursing mother to evaluate a solid mass.

Your letter serves as an important reminder to all Health Professionals working with nursing mothers, and to breastfeeding mothers who are experiencing worrisome breast changes. Thank you for taking the time to share your experience. Best wishes for good health!

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