The diagnosis of breast cancer is devastating and particularly stressful for the lactating mother and her breastfeeding infant. The mother must make treatment decisions which often include having to abruptly end her breastfeeding experience. Management of breast cancer during lactation requires a multidisciplinary approach with the nurse and/or lactation consultant being an important team member. Lactating women receiving a diagnosis of breast cancer require immediate referral to breastfeeding experts who are able to provide them with support and accurate information on weaning strategies. This presentation will utilize a case study of a mother’s journey with breast cancer during lactation. The nurse and/or lactation consultant’s role in identifying and referring suspicious breast lumps/infections will be outlined, and ways to advocate for and support a woman with a diagnosis of breast cancer during lactation will be identified.

Case:  

A 39 year old mother breastfeeding her 9 month old infant presented in the Breastfeeding Clinic, immediately after  receiving a diagnosis of breast cancer at a breast centre, looking for weaning support. Her infant was still breastfeeding seven times per day, had started solids, refused to take a bottle and sippy cup. The lactation consultant worked with this mother to develop an individualized weaning plan. The mother was able to gradually wean over a two week period without developing mastitis, a complication that could delay her cancer treatment. In addition, because weaning is often traumatic for the mother/infant dyad the lactation consultant provided strategies to support the infant during the difficult transition from the breast.

The Advanced Practice Nurse, Nurse Practitioner and Lactation Consultants reviewed the current literature on breast cancer diagnosed during lactation at  a Journal Club and developed a pathway for referring women who present in the breastfeeding clinic with suspicious breast lumps and/or breast infections.

Conclusion:

• only 3% of women develop breast cancer while they are breastfeeding
• because of  the aggressive nature of breast cancer in this age group and the breast changes that occur during  pregnancy and lactation which make detection more challenging, prompt referral of non resolving suspicious breast lumps and/or breast infections is imperative 
• nurses/lactation consultants caring for women in the postpartum period require an awareness of diagnostic tests to rule out or diagnose breast cancer and their implications on breastfeeding and an awareness of weaning strategies for lactating women with a breast cancer diagnosis 

Keywords: pregnancy associated breast cancer, breastfeeding, breast cancer, lactation