Personal health ?

[BakersDozen]

I don't know if this is the right place to post this, but this is the only board I allow myself to get on (I'm a recovering board addict, lol). It's pretty personal so just be warned...

 

I went for my yearly and the nurse was thorough...very thorough! She found a significant mass on my left side. I knew it was there but disregarded it because I'm nursing. I was sent for an u/s (no mammogram thanks to nursing) and there is nothing there. But I can feel it! It's not small, either! The radiologist came in and looked but confirmed no cyst or anything. I spoke to the nurse at my OBs today and she wants me to come in for a "consultation". All my other tests came back normal (thyroid, etc) so I asked why I had to come in but she just said the doctor would want to see me.

 

My questions are: 1) Should I make an appt. and go in? It would cost me $20 which I'd rather not spend just to be told that there is nothing wrong. I'm a bit nervous that my doctor will want to order a mammogram which would mean I have to wean my baby which I do not want to do. 2) Has anyone had something like this and it turned out to be nothing? Not even a cyst? I've had this for years, it doesn't hurt but is a bit tender (which the nurse said was good).

 

I don't want to make a big deal out of something that may not be anything. I've had the tests, nothing was there, can't I just be done with this? And I really, really don't want to wean my baby just for another test.

[gevs4him]

I would call back and tell them you want the Dr. to call you. Have your list of questions ready -like - Could it be something having to do with nursing? I know when I nursed our son I had a gland that would swell up and it was sore at times. If not what do they think it could be? What other test would they want to do and why? Explain to the Dr. you don't want to wean your baby and how important is the test? - can it wait until your baby is done nursing? This is just some questions that I can up with I am sure you can come up with others, but why pay $20.00 when the Dr. should speak to you over the phone. Also If you have had it for years did you ever have a mammogram?

Blessings

Lisa

Edited June 3, 2009 by gevs4him
sp

[BakersDozen]

Also If you have had it for years did you ever have a mammogram?

 

No, I never had a mammogram because I've been nursing for years and just chalked it up to that. I was hoping that my prodding the nurse for the results today would prompt her to say that the doctor would call me...no such luck. I'll try again tomorrow just to see if my OB will call and allow me to not come in.

[Wildiris]

!. I'd go back in because they may want to consult about something different and you won't know without going in.

 

2. Google fibroadinoma. These are nothing to get excited about and perhaps due to a nursing infection. Just something to keep an eye on if it changes. I've had one on the left side for 11-12 years and through two little ones. It fluxuates in size and is movable. I've been poked, prodded and biopsied and a fibroadinoma was the Dr. conclusion. For piece of mind I did do a mammogram, and I did wean little one at 3.5 years to do this; I was also over 40 with a family history of breast cancer, and I got to a point where I just did not wanted to worry anymore.

 

Hope this helps,

[The Girls' Mom]

I have a large one on my right side. I did go in and have a mammogram and US done, and it showed nothing as well. Now I'm just supposed to return for another mammogram this year to make sure nothing has changed, but otherwise was told not to worry about it.

[Jennifer in MI]

I was told I didn't have to quit nursing to get a mammogram. You just need someone familiar with reading a nursing mom's mammo. I ended up not needing one, but was never told that I'd have to quit had it come to that.

 

I have what sounds like the same thing you have! I've had a "mass" in my breast that comes and goes. It's HUGE!! I've had every doctor/midwife look at it when I go in. I was even sent to the specialists once and they have all agreed that it's a milk duct. I've been nursing or pregnant for 13 years now.

[dirty ethel rackham]

There is no need to wean for having a mammogram. The issue has to do with the difficulty reading a mammogram on a lactating breast, but that same difficulty would be there for women under 35 due to the breast density. Here is an excerpt from an article from La Leche League:

 

The discovery of a breast lump often happens as a result of physical touch by the mother, her spouse, or her health care provider. Often, the health care provider will have an idea about the nature of the lump by its feel. Benign lumps usually feel round, smooth and move about in the breast tissue. Cancerous lumps can be irregular in shape, feel "gristly," and are more likely to be fixed in the breast tissue (Love 2000; Margolese et al 1998).

 

The next step is usually a mammogram to help determine the type of lump. Many doctors (and women) believe that a baby must be weaned before performing a mammogram. Lactation can make a mammogram harder to read and may make mammograms for routine screening purposes inappropriate. An experienced radiologist will be able to read a diagnostic mammogram on a lactating breast. This is especially true if the mother has had previous mammograms available for comparison, although this is unlikely for most women of childbearing age. The mother may feel more comfortable if she nurses her baby immediately preceding the mammogram. Ultrasound may also be used for determining the nature of a breast lump but may not be accurate for diagnosing areas of the breast that seem suspicious in a mammogram but contain no palpable lump (Margolese et al 1998; Robidoux et al 1998).

 

Sometimes a mammogram might be diagnostically inconclusive. In these cases, fine needle aspiration can help distinguish between a fluid-filled cyst and a solid mass. Aspiration of a cyst will cause it to collapse and assure that the lump is benign. Lactating women may have milk-filled cysts called galactoceles. These are harmless and can be aspirated or left alone. If the lump is solid, any cells obtained in a needle biopsy can be sent for pathological evaluation. (Love 2000; Margolese et al 1998).

 

If the lump is solid it needs additional evaluation. The health care provider might use a large-bore needle to remove part of the lump for analysis. This technique is also used when the area in question is not a palpable lump but a generalized area of concern seen by mammogram, such as calcifications. While calcifications are benign, some breast cancers look like calcifications on the mammogram so it is important to investigate further. The health care provider will use the large-bore needle to obtain tissue samples from several areas of the mass or suspicious area. If the pathology report shows benign changes in samples from several areas of the lump, the health care provider can be reasonably certain that the benign diagnosis is accurate. If no changes are seen in the tissue, the health care provider may not have obtained an accurate sample and further testing may be appropriate (Robidoux et al 1998).

 

In some cases, an open biopsy, or surgical removal, of the lump or questionable area is appropriate (Margolese et al 1998; Robidoux et al 1998). Lactation might make the surgery a bit trickier because milk may leak if ducts are cut, but does not preclude breast surgery. Some surgeons are not comfortable performing surgery on a lactating breast. They might insist that a mother wean her child before surgery so there is no milk present in the ducts. This is not practical because it can take several weeks to months for all milk to disappear completely and if a breast lump is suspicious the mother will not want to wait. Both mother and surgeon will want to be prepared for the presence of milk, both during the surgery and post-operatively. While this can be messy and may slow healing, it does not pose any danger to recovery. Some surgeons will leave the incision open to allow drainage of milk during healing. Others may insert a drain or wick to collect the extra milk. Still others will close the incision and allow it to heal as they would any other incision (Love 2000).

 

After surgery, the mother can nurse her baby as soon as she feels comfortable. If the incision is close to the baby’s mouth, she might want to pump that breast for a day or so. If she chooses to nurse on that side, she might feel more comfortable if she applies light pressure to the incision with her hand to support it as the baby nurses. She might see some blood or blood-tinged milk coming from her nipple. This is normal and will resolve as the breast heals. The blood will not hurt the baby but s/he might prefer not to nurse on that side. If this is the case, the mother can be encouraged to hand express or pump to maintain her milk supply and relieve discomfort (Love 2000).

 

In the majority of cases (80 percent) the pathology report will confirm that the lump is benign, usually a cyst, fibroadenoma (benign, fibrous tumor), scar tissue, or abscess (Love 2000). If the lump is found to be cancerous, and chemotherapy is the decided course of treatment, the mother will have to wean her baby during the chemotherapy treatments (Hale 2000). If radiation is used, she might be able to continue nursing on the unaffected side. If the cancer is removed by lumpectomy, breastfeeding can continue uninterrupted. Mastectomy obviously precludes breastfeeding on the side where the breast was removed, but the mother can nurse her baby with her remaining breast.

 

Here are a couple more links:

 

Breastfeeding.com on mammograms

 

 

http://yourtotalhealth.ivillage.com/breast-health-can-nursing-mother-get-an-accurate-mammogram.html

 

Good luck to you. Hope everything turns out ok.