ASBrS Executive Summary on Oncolactation

First and Senior Author Reflection on Oncolactation

ASBrS Oncolactation Resource Guide

Vaginal Estrogen Therapy Use and Survival in Females With Breast Cancer

Breast Cancer Screening in Pregnancy and Lactation

Breast Cancer Screening in Pregnancy and Lactation v.2

ACOG Statement on Safety of Imaging During Pregnancy and Lactation

POSITIVE Trial Showing Interruption of Endocrine Therapy is Safe for Pregnancy and Lactation

Editorial on POSITIVE

POSITIVE Trial Showing Breastfeeding is Safe After Breast Cancer

While it’s excellent that we are reporting breastfeeding safety, there still are a couple of important considerations regarding this publication.  First, they didn’t define breastfeeding as exclusive, partial, pumping, or direct.  They cite 30% of patients fed from the affected breast, but do not discuss milk volume, pain, or wounds.  This is unfortunately a flaw of this study.  It is misleading about radiation impact on breast tissue and inability of the vast majority of patients to produce any meaningful milk volume.  It also doesn’t discuss the risks of infant weight loss with a new mom not recognizing her radiated breast is not producing milk like the unaffected breast.  It doesn’t discuss that any ineffective time spent on the radiated breast is time taken away from stimulating the unaffected breast.  It doesn’t discuss that if patients have significant milk production after a nipple sparing mastectomy, they should meet back with their surgeon regarding completion mastectomy of residual tissue.  

The other major issue is that because of lack of details about lactation itself, it is unclear just how many patients had dedicated support in breastfeeding versus those who struggled without help.  We don’t know if the median length of breastfeeding was four months because people stopped voluntarily, because of low milk production, or because of the advice of an oncologist.

While the study overall cites two years safety in interruption of endocrine therapy for both pregnancy and lactation, it doesn’t consider the potential that prolonged breastfeeding could demonstrate a benefit over early resumption of endocrine therapy.  Unfortunately, these comparison studies may not occur, at least in the near future.

Annals of Surgical Oncology Breastfeeding and Breast Cancer

Erika Gergerich Patient Perspective Journal of Human Lactation

Shah et al Management of PABC

Systematic Review of Breastfeeding after Breast Cancer Treatment Annals of Surgical Oncology

Perioperative Lactation Care Model – Memorial Sloan Kettering

BRCA and Breastfeeding Reduced Risk of Ovarian Cancer

Preventing Ovarian Cancer with Breastfeeding (All Populations)

Ovulation and BRCA and Ovarian Cancer Prevention

Breast Cancer Detection in Breastmilk

Breastfeeding during Breast Cancer:  What You Need to Know (Sutter Health Vitals).

 The Joy—and Fear—of Breastfeeding with BRCA1 _ Vogue