Pregnancy and lactation after breast-conserving therapy for early stage breast cancer

To identify patients treated with breast conservation therapy for early-stage breast cancer who subsequently experienced full-term pregnancies, and to identify: (1) The proportion of women who experienced lactation in the treated breast; and (2) treatment, disease, and/or host factors that may be related to the presence or absence of lactation and the ability to breast-feed successfully.

The records of 890 patients treated at the radiation therapy facilities of the Department of Therapeutic Radiology, Yale University, New Haven, CT, for early-stage (Stage I or II) breast cancer were reviewed to identify patients who had become pregnant subsequent to completing breast conservation therapy. Data were collected from the patients' departmental records, and interviews were conducted by phone and/or questionnaire.

Thirteen patients were identified, and 11 patients who experienced 13 pregnancies were interviewed. All patients reported little or no swelling of the treated breast during pregnancy. After delivery, lactation from the treated breast was present in four instances, absent in six, and pharmacologically suppressed in three. One patient successfully breast-fed from the treated breast for 4 months. In the majority of cases, breast-feeding from the untreated breast was successful. The interval from the time of treatment to the time of delivery did not appear to affect adversely lactation from the treated breast; one patient reported lactation from the treated breast 75 months after completion of treatment. Circumareolar incision was associated with the absence of lactation in three patients (four pregnancies). Thus, lactation from the treated breast may be less likely to occur in the case of centrally located lesions.

Successful breast-feeding from the untreated, as well as the treated breast, is possible after conservative surgery and radiation. Implications for patients of child-bearing age undergoing conservative surgery and radiation therapy are discussed.