breast examinations

I met someone today who is in need of a full breast screening, a
specific problem as well has her being 40 is the reason. She is
breastfeeding a 19mth old.

She has been referred by her doctor for breast MRI, but she cannot find
a radiologist who is prepared to do it, the contrast mediums all appear
to be compatible with breastfeeding, it more seems to be that they are
not prepared to read it and say it's clear (if that were the case),
simply because a lactating breast is not one which can be read so
accurately.

Does anyone have any ideas at all? We're in the Seattle area.

It would seem to me that they should do it and the report should say,
presuming they find nothing, that nothing was seen, with a caution that
it would be less accurate, as it is a lactating breast - as it is it's
being delayed whilst she finds someone, surely it's better if there is a
problem to try to get a result, instead of her spending time looking for
someone, whilst potentially a problem gets worse, I wouldn't be
surprised if there was a family history of breast cancer as she
mentioned she'd had a mammogram 7 years ago.

Cheers
Anne

I might be wrong, but I think a lactating breast looks as though it
has growths inside, and it is therefore not possible to detect whether
one of those 'growths' is cancerous or not without checking it through
an operation. In other words, if they do the breast MRI, it will look
as though there is a problem and they will have to do one of those
operations whether they check whether or not something is cancerous
(sorry, forgot the word). I might be completely wrong though, but
that is how I understood it.

I think Sarah Vaughn is on this forum, she might now?

-x-
Jolande

On Aug 21, 7:56 am, Anne Rogers wrote:
I met someone today who is in need of a full breast screening, a
specific problem as well has her being 40 is the reason. She is
breastfeeding a 19mth old.

She has been referred by her doctor for breast MRI, but she cannot find
a radiologist who is prepared to do it, the contrast mediums all appear
to be compatible with breastfeeding, it more seems to be that they are
not prepared to read it and say it's clear (if that were the case),
simply because a lactating breast is not one which can be read so
accurately.

Does anyone have any ideas at all? We're in the Seattle area.

It would seem to me that they should do it and the report should say,
presuming they find nothing, that nothing was seen, with a caution that
it would be less accurate, as it is a lactating breast - as it is it's
being delayed whilst she finds someone, surely it's better if there is a
problem to try to get a result, instead of her spending time looking for
someone, whilst potentially a problem gets worse, I wouldn't be
surprised if there was a family history of breast cancer as she
mentioned she'd had a mammogram 7 years ago.

Cheers
Anne

I kmow that they postponed Monika's baseline mammogram until she was
finished nursing even though she was 5 years overdue. (That's what
happens when you have a kid at 39 and nurse 5+ years).
Larry


In article ,
says...
I met someone today who is in need of a full breast screening, a
specific problem as well has her being 40 is the reason. She is
breastfeeding a 19mth old.

She has been referred by her doctor for breast MRI, but she cannot find
a radiologist who is prepared to do it, the contrast mediums all appear
to be compatible with breastfeeding, it more seems to be that they are
not prepared to read it and say it's clear (if that were the case),
simply because a lactating breast is not one which can be read so
accurately.

Does anyone have any ideas at all? We're in the Seattle area.

It would seem to me that they should do it and the report should say,
presuming they find nothing, that nothing was seen, with a caution that
it would be less accurate, as it is a lactating breast - as it is it's
being delayed whilst she finds someone, surely it's better if there is a
problem to try to get a result, instead of her spending time looking for
someone, whilst potentially a problem gets worse, I wouldn't be
surprised if there was a family history of breast cancer as she
mentioned she'd had a mammogram 7 years ago.

Cheers
Anne

Hi Anne,
I think the reasons are as explained - not that it's dangerous in any way to
the baby, but that the presence of milk in the ducts makes it hard to read
the results. Same reasons they don't do smears when you're pg.

Is there another way they can do a diagnosis?

Morag

"Anne Rogers" wrote in message
...
I met someone today who is in need of a full breast screening, a specific
problem as well has her being 40 is the reason. She is breastfeeding a
19mth old.

She has been referred by her doctor for breast MRI, but she cannot find a
radiologist who is prepared to do it, the contrast mediums all appear to
be compatible with breastfeeding, it more seems to be that they are not
prepared to read it and say it's clear (if that were the case), simply
because a lactating breast is not one which can be read so accurately.

Does anyone have any ideas at all? We're in the Seattle area.

It would seem to me that they should do it and the report should say,
presuming they find nothing, that nothing was seen, with a caution that it
would be less accurate, as it is a lactating breast - as it is it's being
delayed whilst she finds someone, surely it's better if there is a problem
to try to get a result, instead of her spending time looking for someone,
whilst potentially a problem gets worse, I wouldn't be surprised if there
was a family history of breast cancer as she mentioned she'd had a
mammogram 7 years ago.

Cheers
Anne

Anne Rogers wrote:

It would seem to me that they should do it and the report should say,
presuming they find nothing, that nothing was seen, with a caution that
it would be less accurate, as it is a lactating breast - as it is it's
being delayed whilst she finds someone, surely it's better if there is a
problem to try to get a result, instead of her spending time looking for
someone, whilst potentially a problem gets worse

Depends on the likelihood that there is a problem. The risk of a false
positive with consequent unnecessary treatment has to be balanced
against the risk of missing a problem. What's the clinical indication
for the scan?


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

Jolande wrote:
[...]
I think Sarah Vaughn is on this forum, she might now?

Not my field at all, but I've posted the query on a medical forum.


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

Morag in Scotland wrote:
Hi Anne,
I think the reasons are as explained - not that it's dangerous in any
way to the baby, but that the presence of milk in the ducts makes it
hard to read the results. Same reasons they don't do smears when you're pg.

Is there another way they can do a diagnosis?

I simply don't know enough about the particular circumstances, the
mother asked the question during a la leche league meeting, the topic is
interesting to me and I wanted to find out more, with the bonus that if
I did find something, I could pass it on to her via the group leader.

She was pretty clear that it wasn't "just" screening - screening in the
US is yearly from 40 anyway, when it comes up with breastfeeding women,
often the answer is to just wait, but if there are any risk factors
that's not going to be the case, my mum had breast cancer at 43, if I
happen to be breastfeeding anywhere near that age, skipping screening
isn't a great option.

Ultrasound was suggested, but apparently it's not that good for
screening the whole breast, just for looking at specific lumps - but I
don't know how conclusive the answer is even on specific lumps during
lactation, I had a lump examined by ultrasound during breastfeeding, it
was expected to be an abscess and the plan was to drain it, but when
they found it to be a solid lump, that was all they could say about it,
solid.

Cheers
Anne

Depends on the likelihood that there is a problem. The risk of a false
positive with consequent unnecessary treatment has to be balanced
against the risk of missing a problem. What's the clinical indication
for the scan?

I really don't know much detail. I wouldn't be surprised if a British
doctors evaluation of the situation would be quite different to that of
an American doctor - given the baseline difference in screening, from 50
and 3 yearly in the UK, compared to from 40 and yearly in the US. She
did say she had a problem rather than it being routine screening. I
guess I'm looking for some non specific information, such as data on how
reliable results are from the various tests when lactating, the breast
MRI has been requested by her doctor, though I don't know which type of
doctor, so it's entirely possible s/he isn't highly knowledgeable about
the subject, if they were they'd probably know which radiologists would
and wouldn't so it.

Cheers
Anne