Curious about what motherhood has to do with breast and ovarian health?
Becoming a mom is quite an undertaking, both emotionally and physically. Our bodies go through changes, and while some of them more visible than others (oh, hello stomach wrinkles), a few of those changes impact our breast and ovarian cancer risk!
Let’s start with pregnancy. Pregnancy transforms and stabilizes the cells in our breasts that comprise milk-producing glands and ducts, so the earlier this transformation happens, the lower the risk of breast cancer. Some studies have shown that women with first pregnancies under the age of 30 have a 40-50% lower risk of breast cancer than women who gave birth later or who were never pregnant.
Pregnancy can also reduce your risk of ovarian cancer. During pregnancy, your body is not ovulating. The lack of our monthly cycle during this time decreases the amount of ovarian cell activity and therefore the number of chances for ovarian cells to “go rogue” during cell division.
Breastfeeding can also play a role in your risk reduction strategy. Though breastfeeding may not be for everyone, breastfeeding for 1-2 years (not necessarily consecutively), can lower your risk for both breast and ovarian cancer. When breastfeeding, many women do not ovulate. So similarly to pregnancy, this break in ovarian cell activity can be protective for your ovaries, and all decreases the amount of estrogen in your body. It also may reduce a female baby’s overall risk of developing breast cancer later in her life.
During pregnancy and breastfeeding, our breasts go through a TON of changes (thank you hormones).. In order to practice breast self-awareness during this time, It’s important to know what changes are expected, and what might merit a conversation with a provider. Although pregnancy associated with breast cancer is rare, it is important to be aware of the possibility. Make sure you notify your provider about any new symptoms including the following:
Breast changes during pregnancy and breastfeeding:
- Tenderness & discomfort
- Blue veins
- Darker areolas
- Areola bumps
- Nipple discharge of colostrum, a thick yellow liquid that boosts the immune function of newborns in the very early stages of breastfeeding
- Stretch marks
Things to bring to your provider:
- Unusual nipple discharge that is unlike colostrum
- Breast lumps. Usually, these lumps are not a cause for concern. They are often either: galactoceles, which are clogged milk ducts, or fibroadenomas, which are benign breast tumors. These symptoms are likely to be harmless, but it is a good idea to have an expert take a look because of how complicated our lady parts can be during this time
- Swelling, soreness or rash
- Warmth, redness or darkening
- Dimpling or puckering of skin
- Itchy, scaly sore or rash on nipple
- Nipple that becomes flat or inverted
- New, persistent pain in one spot
- Persistent itching
- Bumps that resemble bug bites
- Cyst (benign mass made of water) including galactoceles and fibroadenomas.
If a new or suspicious symptom does arise in pregnancy, your provider may recommend consultation with a breast radiologist for diagnostic imaging of the breast. During pregnancy, the imaging work up usually starts with an ultrasound. During breast feeding, a mammogram may sometimes also be performed along with an ultrasound for evaluation in a patient with symptoms. If you are breastfeeding and a mammogram is going to be performed, your radiologist will likely ask you to pump or feed before the mammogram. Some breast centers have hospital grade pumps available, but if you’re more comfortable with your own, bring it just in case!
For high-risk women without symptoms who have started an annual screening program, mammograms and MRI examinations will not be performed during pregnancy. However, bilateral whole breast ultrasound is a great alternative screening tool during pregnancy. Although mammograms can be obtained during breastfeeding, they are limited due to lactation changes and again bilateral whole breast screening ultrasound may be a good alternative for screening during this time in high-risk patients. You can contact your breast imaging center to find out when they recommend resuming annual screening mammography after pregnancy (most places recommend 3-6 months after breast feeding). Screening MRI can be resumed once breast feeding is finished.
The ongoing struggle: managing motherhood and your health
Motherhood comes with so many rewards, but also great challenges. Balancing the demands of family responsibilities along with other life pressures can be tricky. The one thing that should not be sacrificed amongst it all is Y-O-U! It is imperative to take time to keep up with your annual well-woman exams, cancer screenings, and healthy lifestyle behaviors. Not only for your own health but to also set a wonderful example for your children!
Here are some resources for the moms in our community managing their breast and ovarian health while raising kids: