Breastfeeding and imaging. Waiting is terrible.

Pugmama83 · July 2020

I have previously posted in the not diagnosed thread. I am 36 years old and 4mo postpartum and have due to breast concerns stopped breastfeeding. I have two indents, puckering areas below my left breast. I have had a 3D mammogram and two separate ultrasounds specifically of the lower inner quadrant of my left breast both clear I have heterogeneously dense breast. I first went to my ob who referred me to a BS regarding it. I apparently need to be flexing or bending over to best show the indentations and overhead light does not help. Everyone I have seen so far says they are having difficulty replicating what I have been able to capture in pictures. The BS has placed a order for a MRI which I will need to pay for out of pocket. I have read that Breastmilk can effect imaging so have am trying to dry it up prior to paying such a high expense.

I can't look in the mirror anymore. It's all I think about. I have read very alarming and just plaindepressing information about Pregnancy and Postpartum associated Breast Cancer. That it tends to be very aggressive with low survival rates.

I don't know what to do. Waiting for my milk to dry up or not? My BS seemed to honestly brush me off about it. Said come back if it's still there after breastfeeding, and get a new ultrasound and mammogram in 6mo.

I just want a clear answer as to what is going on cause my anxiety is in overdrive.

I think I would have been better if I had not noticed a second puckering on the outer inner of my left breast. This was seen after my appointment with the BS. I sent him a message about it with not much response. I feel like the boy who cry's wolf.

So long story short, is it advisable to wait. Will milk cause issue with a MRI?

Mavericksmom · July 2020

Congratulations on your new baby.

You don’t say how old you are or why you think you have breast cancer, other than the puckering. Do you have a family history of breast cancer? Is this your first baby?

I don’t know anything about nursing moms and MRI, so I am sorry, I can’t give advice on that.

Puckering can be normal. Normal US and mammogram are a good start. Are your breasts red?

Did your insurance deny an MRI?

Breasts change a lot after having a baby. Please add more information as to why you think you have breast cancer. There are a lot of young women here who will hopefully have information for you. Sorry I can’t be more helpful

Pugmama83 · July 2020

Hi, Maverick. I hope it is just change due to breastfeeding. I have two indents, puckering areas under my left breast. One about a inch long on the bottom inner that changes the contour of my breast when my arm is raised and one much smaller making a crease on my outer bottom. The seem to mirror my nipple. They are most visible when I bend over with a mirror and flex. I have also been having stabbing pain. Keep in mind I am now weaning. My OB said she felt a lump but my GP and BS have not felt a lump. The longer indent was reviewed with a ultrasound twice. No findings. I did not see the smaller indent till after my last appointment on 7/8. I did email the BS surgeon about it. I have no current explanation for the indents just wait and see. My family has no history of cancer. I am 36. No symptoms of IBC. In my last post I was told only a MRI or Biopsy would be sufficient. That dense breast can hide things

Beesie · July 2020

Mavericksmom. most of the background is explained in Pugmama's earlier thread: https://community.breastcancer.org/forum/83/topics...

Pugmama, have the indents/puckering changed/gotten more prominent?

I think it's good that you will be getting the MRI. However as I mentioned in your other thread, keep in mind that you may not get the clear answer that you are looking for. If the MRI is clean - which is hopefully the case - it won't explain what is causing these indentations. If it's changes in the breast caused by breastfeeding, which is most likely the case (particularly since you've had several clear screenings with 3D mammogram and ultrasound), I doubt that this would show up on an MRI.

In a different thread, djmammo replied to your question about how long to wait to have an MRI after stopping breastfeeding by suggesting that you call the MRI facility to ask. Have you done that?

Mavericksmom · July 2020

Thanks for the link Beesie!

I read her original post but didn't go through all the responses.

I had pains when I nursed both my children and when I was weaning them. I feel bad that you stopped nursing because of this. I am a huge advocate of nursing vs formula. I had to switch to formula with my first due to medical issues, and both my children grew up to be healthy adults with healthy children of their own, but nursing is better for infants. By the way, studies have linked nursing babies to decreased risk of breast cancer.

Lumps and indentations are normal when you are breast feeding too. I had them, but when I had my children, women just looked to the advice of their doctors as it was pre-home computers, internet etc. (1980's) Sometimes too much information can work against us, but this is the age we live in, so we are all doing on line research for every health ailment we have. It can be a very good thing, but also can cause excess worry leading to excess testing.

At least MRI's aren't harmful like CT scans. I am not sure you will really have peace of mind after the MRI, but it doesn't sound like you will have any without the test.

I think you made your decision. Let us know the results!

I wanted to add: See if your BS can resubmit the request for an MRI under a different code so the insurance company will pay.

If that doesn't work, whatever you do, DO NOT PAY the full amount the hospital bills you! You can negotiate a lesser price. NO ONE SHOULD EVER PAY FULL COST OF a procedure or major test! Hospitals ALWAYS take something off the cost, talk with the billing dept. manager. This is true in USA, I don't know about other countries.

MelissaDallas · July 2020

MRIs are not completely “harmless” because of the gadolinium contrast and the documented growing concern over whether or not the contrast remains deposited in our brains.. Additionally, the fact that they are very sensitive and also very nonspecific lead to many (benign) biopsies. There are trade-offs to demanding to be endlessly reassured, includingfinancial concerns for paying out of pocket for unapproved and unindicated MRIs and biopsies being among them.

Mavericksmom · July 2020

Good call, Melissa! I forgot about that!

djmammo · July 2020

Pugmama83

The 6 month waiting rule applies only to screening mammograms.

If there are symptoms or palpable abnormalities we don't recommend waiting.

Mavericksmom · July 2020

djmammo, I’m confused. I was told to wait and have another US in six months for possible fat necrosis, after finding a suspicious lump. (Felt by MO too) I had breast cancer twice. My mammogram and ultrasounds were diagnostic. Apparently not all radiologists do it that way, which I guess is possible. Unfortunately patients can’t pick their radiologists like we can our doctors

Are 3-D mammograms always diagnostic, or the fact that she was sent for one due to a lump made it diagnostic?

Beesie · July 2020

Mavericksmom, were your diagnostic mammo and ultrasound results rated BIRADs3? That's usually what triggers a 6 month follow-up.

3D mammos can be screening mammos. Diagnostic mammos use magnification and extra imaging to target in on areas of concern:

Mammography is X-ray imaging of your breasts designed to detect tumors and other abnormalities. Mammography can be used either for screening or for diagnostic purposes in evaluating a breast lump:

Screening mammography. Screening mammography is used to detect breast changes in women who have no signs or symptoms or new breast abnormalities. The goal is to detect cancer before clinical signs are noticeable.
Diagnostic mammography. Diagnostic mammography is used to investigate suspicious breast changes, such as a new breast lump, breast pain, an unusual skin appearance, nipple thickening or nipple discharge. It's also used to evaluate abnormal findings on a screening mammogram. A diagnostic mammogram includes additional mammogram images. https://www.mayoclinic.org/tests-procedures/mammogram/about/pac-20384806

Mavericksmom · July 2020

Thanks Beesie, so it is based on BIRAD number not screening vs diagnostic or mammogram vs ultrasound.

Got it!

Pugmama83 · July 2020

Called to schedule the MRI, brought up the breastfeeding question and the BS said I need to dry up my milk first and that can sometimes take months. Definitely feel like I am in Limbo

JonathanGill · September 2020

Yes, it could be the milk. Your mammary glands are enlarged and because of this poor visibility. Ask your doctor for pills that stop the arrival of milk.

Anonymous · September 2020

Omg, i'm so sorry to hear this...Milk depends just on you, try to relax, the main enemy is stress!!

Pugmama83 · September 2020

Jonathan, thank you. Yes, I was placed on sudafed for two weeks and told to wait till my first cycle passed. I called today to schedule the MRI.

ShetlandPony · September 2020

Pugmama, I’m so sorry you have to do this. Maybe a lactation consultant would be a good helper?

Pugmama83 · September 2020

Shetland, thanks for your concerns. My OB said at this point it would be detrimental to restart breastfeeding even if the imaging came back clear that the decongestant should be the answer. She thinks it's a good idea I get it done as she too saw the indent, but felt no lumps. Would rather I be safe. My baby has severe food allergies so in the end of the day it might work out for the best. Regardless that is all small potatoes stress compared to what women on here face so I am taking it day by day.

ShetlandPony · September 2020

I just meant maybe a lactation consultant couldhelp you and baby be as comfortable as possible through weaning under these circumstances.

Pugmama83 · September 2020

Just wanted to update the post. The breast surgeon called me today and said the results of my MRI looked normal. I just needed to follow-up in 3 months for a Mammogram and Ultrasound to keep an eye on things. Thank you ladies you are wealths of knowledge I am very greatful

MinusTwo · September 2020

Congrats. Thanks for the update

Beesie · September 2020

Great news! Thanks for letting us know.

Now go off and enjoy that wonderful baby of yours!

Breastfeeding and imaging. Waiting is terrible.

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