The breast goes through many significant changes during pregnancy and lactation, but this does not mean that a new, cancerous lump would be impossible to find. However, since lactating breasts tend to be somewhat irregular in form, it can be more difficult to determine whether a persistent lump is reason for alarm. After checking with your doctor, consider following this basic routine for performing a breast self-exam during lactation.
When to Perform a Breast Self-Exam while Nursing
To minimize the chances of tenderness or fibrocystic changes, most physicians recommend that all women conduct breast self-exams one week after menstruation, since this is when the breasts are the least likely to be sore or contain benign cysts. Since many breastfeeding women do not menstruate regularly, it is a best for nursing mothers to check their breasts twice per month.. If your period has returned to a regular cycle, you can follow the typical recommendation of doing a breast self-exam monthly, directly after menstruation.
Allow your child to nurse fully on both sides before doing a self exam, or express enough milk that your breasts become essentially "empty". A lactating mother's milk ducts are never completely void, but it is easier to do an exam if there is less milk in your breasts. This minimizes pain and tenderness, while also enabling the most realistic understanding of underlying breast tissue.
How to do a Breast Self-Exam While Nursing
To examine your own breasts and screen for breast cancer and other potentially dangerous problems, lie flat on your back-- a breast exam should always be done lying down. If your breasts are prone to leaking, have a rag or burp-cloth on hand to wipe any spilled milk. Place your right hand behind your head, and use the three middle fingers of your left hand to palpate your right breast. Use overlapping, nickel-sized, circular motions to feel each part of your breast with your finger pads.
Touch each part with varying degrees of pressure-- light pressure to feel close to the surface, hard pressure to feel deeper tissue. Use up-and-down motion, with this pattern, until you have covered your entire breast area. You should thoroughly examine every area from your underarm to your sternum, and from your collar-bone to your lower ribs. When you have finished your right breast, use your right hand to conduct the same exam on your left breast.
Help! I've Found a Lump!
You might find a lump while you are doing a self-exam during lactation. While this is not something to be ignored, it is also not necessarily a reason to panic. Benign, mildly plugged ducts are most common cause of breast lumps for nursing women. If the lump is tender, this is most likely the cause. If the tender lump still persists after nursing or pumping again, contact your doctor, since it may be a milk cyst or breast abcess.
A persistent, hard, non-tender lump can also be very alarming, especially if it is not relieved by nursing. These are most often caused by fibrocystic breast changes, which are benign, but they can also be caused by trauma or calcifications in the breast tissue. Although it is unlikely that the lump is cancerous, it is still very important that you contact your doctor to be on the safe side. He or she can advise you about what should be done next.
An Important Note about Breast Self-Exams
Breast self-exams are important, but they are not a certain, definitive method for detecting or diagnosing breast cancer at home-- during lactation or any other time. All women over twenty should have a clinical breast exam at least once every three years, performed by a qualified physician. Women over forty (or who are at high risk of developing breast cancer) should see their doctor at least once per year to ensure the continued health of their breast tissue.
By choosing to breastfeed, you have already made an important step in guaranteeing your health and your child's health. Breast self-exams are also a very important part of maintaining your general health, by detecting cancer early. Too many women's lives have already been lost to cancer-- but with education, early detection, and speedy treatment, we can eliminate this tragic disease once and for all.