ABSTRACT
Breastfeeding is an important aspect of mother-newborn relationship and is of great benefit for the baby. Unfortunately, many drugs taken by the mother may pass into her milk and exert an effect on the newborn. Very limited data is available and a cautionary approach is warranted especially when the woman receives anticancer treatment including chemotherapy , hormonal treatment and the recently introduced target agents as well as monoclonal antibodies. In all these conditions breastfeeding should be put on hold.More and more often physicians are faced with women that are pregnant years after the diagnosis of cancer: this has long been considered dangerous for the mother, but data show that prognosis is definitely not worse. If the woman is no longer being actively treated, breastfeeding is advisable every time it is possible, even if patients that received breast radiation may be unable to produce a sufficient amount of milk on that side.
Subject(s)
Breast Feeding , Breast Neoplasms/therapy , Lactation , Pregnancy Complications, Neoplastic/therapy , Breast/radiation effects , Female , Humans , Infant, Newborn , Lactation/radiation effects , Milk, Human/metabolism , Pregnancy , Time FactorsSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Feeding , Lymphoma, Large B-Cell, Diffuse/drug therapy , Milk, Human/chemistry , Pregnancy Complications, Neoplastic/drug therapy , Adult , Allopurinol/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/analysis , Chromatography, Liquid , Cyclophosphamide/administration & dosage , Cyclophosphamide/analysis , Cyclophosphamide/metabolism , Doxorubicin/administration & dosage , Doxorubicin/analogs & derivatives , Doxorubicin/analysis , Doxorubicin/metabolism , Female , Humans , Infant, Newborn , Lymphoma, Large B-Cell, Diffuse/diagnosis , Mass Spectrometry , Prednisone/administration & dosage , Pregnancy , Pregnancy Complications, Neoplastic/diagnosis , Rituximab/administration & dosage , Vincristine/administration & dosageABSTRACT
An increasing number of women are diagnosed with cancer during pregnancy and lactation. Women are usually advised to interrupt breastfeeding during systemic anticancer treatment for fear of serious adverse effects to the nursed infant. However, the issue is poorly addressed in the literature and very few studies have evaluated the safety of breastfeeding during or after cytotoxic drugs or target agents administration. In this review we will analyze the available evidence that addresses the issue of anticancer drugs, targeted agents, antiemetics and growth-factors excretion in human milk. This could serve as a unique resource that may aid physicians in the management of breastfeeding cancer patients interested in maintaining lactation during treatment.
Subject(s)
Antiemetics/pharmacokinetics , Antineoplastic Agents/pharmacokinetics , Breast Feeding , Breast Neoplasms/metabolism , Intercellular Signaling Peptides and Proteins/pharmacokinetics , Lactation/metabolism , Milk, Human/metabolism , Pregnancy Complications, Neoplastic/metabolism , Antiemetics/adverse effects , Antineoplastic Agents/adverse effects , Breast Neoplasms/drug therapy , Drug-Related Side Effects and Adverse Reactions/chemically induced , Female , Humans , Infant, Newborn , Intercellular Signaling Peptides and Proteins/adverse effects , Male , Pregnancy , Pregnancy Complications, Neoplastic/drug therapyABSTRACT
Little is known regarding the safety and feasibility of breastfeeding in women with a history of breast cancer. We have performed a survey among breast cancer patients who completed their pregnancy following breast cancer management to examine their lactation behaviours and its effect on breast cancer outcome. Out of 32 women identified, 20 were reachable and accepted to take the questionnaire. Ten women initiated breastfeeding, 4 stopped within one month and 6 had long-term success with a median period of 11 months (7-17 months). The latter were all previously subjected to breast conserving surgery and received qualified lactation counselling at delivery. The main reasons for not initiating breastfeeding were "uncertainty regarding maternal safety" and "a priori unfeasibility" expressed either by the obstetrician or by the oncologist. At a median follow-up of 48 months following delivery, all 20 women were alive with two relapses; one in each group (i.e., lactating and non-lactating). This analysis adds to the limited available evidence on the feasibility and safety of breastfeeding in breast cancer survivors. Proper fertility and survivorship counselling is crucial and requires more attention in breast cancer clinics.
Subject(s)
Breast Feeding , Breast Neoplasms/therapy , Lactation , Neoplasm Recurrence, Local/epidemiology , Adult , Disease-Free Survival , Female , Humans , Pregnancy , Safety , Surveys and Questionnaires , SurvivorsABSTRACT
Breast cancer is the most common malignant tumor-affecting women during the child bearing period. With the rising trend in delaying pregnancy later in life, the issue of subsequent pregnancy and lactation following breast cancer diagnosis has been more frequently encountered. In this context, data is scarce particularly those addressing the issue of lactation. In this review, we discussed different endocrinal, clinical and biological aspects dealing with breast-feeding after breast cancer in an attempt to determine how safe and feasible this approach is.
