Pregnancy, Breastfeeding and High Risk Screening
Pink Hope Outreach Ambassador Robyn shares her personal experience of undertaking high risk screening while pregnant and breastfeeding.
Breasts are awesome on so many levels. So when I found out that I carried the BRCA2 mutation and was advised to remove them to reduce my risk of breast cancer, I was disappointed. I was pregnant with my second child when I found out that I was high risk for developing breast and ovarian cancer and since then, I have gone on to have a third child. Each to their own, but breastfeeding for me is a big part of having a baby so instead of having preventative surgery, I decided to continue with regular surveillance and screening as my way of dealing with my increased risk. And after all, breastfeeding ‘they say’, reduces your risk of breast cancer.
So having been pregnant or breastfeeding for the best part of 5 years now, it’s safe to say that I know a lot of the ins and outs surrounding what is ok for mothers to do with respect to surveillance. Each year I have an MRI, ultrasound and a mammogram to keep an eye on changes in my breast tissue. Of course I do a monthly ‘check’ myself and feel for any unusual lumps and bumps but most people will know that when you are breastfeeding, there can be many different lumps and bumps that are perfectly normal.
There is a common misconception that breastfeeding mothers can’t have MRIs, however the level of contrast (usually gadolinium) that a baby would receive through breast milk after a mother has an MRI is so low that it is considered safe these days. To be on the safe side, I would always feed my baby right up until the time of my MRI, then wait as long as I could until the next feed, thus ensuring that there would be minimal contrast in my system. You can always ‘pump and dump’ if your baby is clever enough to take a bottle.
While all mothers need to look after themselves, it is particularly important for breastfeeding mothers as they have greater demands on their body. One winter’s day, I was off to have my annual MRI and I was particularly tired (due to three kids not sleeping well) and I’d not kept myself very hydrated. I was ready for my MRI but when the lovely nurses gently inserted the cannula into my forearm, I promptly passed out in the chair and woke up in a sea of breast milk and worried faces. I have low blood pressure generally but when pregnant or breastfeeding, my blood pressure is very low. Add to that being tired and not well hydrated and this was the result I got. I was very well looked after by the imaging staff and after a short wait recuperating and hydrating I successfully had my MRI. I hope others can learn from my silly experience and look after themselves better!
We are so fortunate that these days, there isn’t much medically you can’t do while pregnant or breastfeeding.
I have had an MRI, a mammogram, breast ultrasound and even a fine needle aspiration all while pregnant or breastfeeding. Sure there were extra precautions that were in place to ensure the safety of everyone, but it’s a small price to pay for screening that could save my life. Unfortunately the reality of being high risk means that there will be times (and there are) when I need to visit my doctor to get lumps or bumps checked out and while it’s annoying, that is just the way it is. For now I will continue with the regular screening I do and enjoy having my breasts while I can and then one day in the future when the time is right, I will make a decision about further risk reduction. I really hope that my experience doing screening and surveillance while being pregnant or breastfeeding can help other women who are grappling with the decisions related to having a family while being high risk.