Breastfeeding and Breast Cancer: Lumps, Screening & Breast Cancer Risk | Dr Ajesh Raj Saksena and the

By Dr Ajesh Raj Saksena, Surgical Oncologist, Hyderabad — Breast Cancer Surgeon in Hyderabad with 15 Years of Experience in Surgery

Breastfeeding is an important part of early motherhood for many women. It provides valuable nutrition and immune protection for the baby and offers several health benefits to the mother as well.

One of those benefits is particularly relevant from a cancer prevention perspective: breastfeeding is associated with a lower risk of developing breast cancer. However, another message deserves equal attention. Breast changes are extremely common during breastfeeding, and most are harmless, but a persistent breast lump or an unusual change should not automatically be attributed to lactation.

As a Breast Cancer Surgeon in Hyderabad with 15 years of experience in surgery, I often emphasise a simple principle: breastfeeding is protective, but it does not make a woman immune to breast cancer.
Understanding what is normal during lactation and knowing when to seek medical advice can prevent unnecessary anxiety while also avoiding delays in diagnosis.

Does Breastfeeding Reduce the Risk of Breast Cancer? Yes. Research has consistently shown an association between breastfeeding and a reduction in a woman’s lifetime risk of breast cancer.

The protective effect appears to increase with the total duration of breastfeeding across pregnancies.

Several biological mechanisms may contribute to this protection. Breastfeeding reduces the number of menstrual cycles a woman experiences and therefore alters cumulative exposure to reproductive hormones. Pregnancy and lactation also cause breast cells to undergo important changes in maturation and renewal.

This does not mean that breastfeeding completely prevents breast cancer. It is better understood as one of several factors that may reduce lifetime risk.

Family history, inherited genetic mutations, age, hormonal factors, lifestyle and several other influences also contribute to an individual’s breast cancer risk.

Does Breastfeeding Protect Against Breast Cancer?

Yes. The research has found a connection between breastfeeding and the reduction of the risk of breast cancer for a woman in her life.

Moreover, the duration of breastfeeding has been shown to have a positive effect on the degree of protection.

There could be a number of reasons behind this connection. First, breastfeeding reduces the number of menstrual cycles experienced by a woman and changes her reproductive hormonal environment. Secondly, breast feeding also affects the maturing and renewal of breast tissue.

It should be noted that breastfeeding cannot be considered as a complete protection against breast cancer. It is rather one of the many factors reducing lifetime risk of developing the disease.

Other factors that affect breast cancer risks include family history, genetic mutations, age, hormones, lifestyle and others. When Should a Breast Lump During Breastfeeding be checked.

A new lump during lactation does not automatically mean cancer. In fact, a benign cause is much more likely.

Nevertheless, you should consider seeing your doctor if a breast lump:

● persists despite feeding or expressing milk
● repeatedly occurs in the same location
● progressively increases in size
● feels distinctly hard or fixed
● does not improve following appropriate treatment for mastitis
● is associated with persistent skin thickening or dimpling
● causes a new nipple change or retraction
● is accompanied by an unexplained lump in the armpit

The important point is not to panic about every breast change.
The goal is to avoid ignoring a persistent one.

Is Breast Ultrasound Safe While Breastfeeding?

Yes.

If a breast lump requires investigation during lactation, breast ultrasound is commonly the first imaging test performed, particularly in younger women.

Ultrasound can help distinguish between conditions such as:

● simple or complicated cysts
● galactoceles or milk-filled cysts
● abscesses
● benign solid breast lumps
● lesions that require further assessment

Ultrasound does not use ionising radiation and does not interfere with breastfeeding.

Can You Have a Mammogram While Breastfeeding?

Yes.
A mammogram can be performed during breastfeeding when clinically indicated.

Breast tissue is often denser during lactation, which can make interpretation more challenging. Feeding or expressing milk shortly before the examination may reduce breast fullness and improve comfort.

The decision to perform mammography should be based on the woman’s symptoms, age, examination findings and the results of other investigations.

Breastfeeding itself should not be a reason to postpone necessary breast imaging.

Can a Breast Biopsy Be Done During Breastfeeding?

Yes.

If imaging identifies an abnormal area that requires tissue diagnosis, a core needle biopsy can generally be performed during lactation.

Women should inform their radiologist and breast surgeon that they are breastfeeding so the procedure and aftercare can be planned appropriately.
A recommendation for biopsy does not necessarily mean that cancer is present. A biopsy is simply the most reliable way to determine the nature of a suspicious or uncertain breast lesion.

Delaying a necessary biopsy solely because a woman is breastfeeding is usually not appropriate.

Can a Woman Breastfeed After Breast Cancer Surgery?

In many situations, yes.

The ability to breastfeed after breast cancer treatment depends on the type of surgery and whether the breast has received radiation therapy.

After Breast-Conserving Surgery

Women who have undergone lumpectomy or breast-conserving surgery may have reduced milk production from the treated breast, particularly if radiation therapy was subsequently given.

Milk production depends on how much glandular tissue was removed and how treatment affected the breast ducts and surrounding tissue.

After Mastectomy

A breast that has undergone mastectomy cannot produce milk because the milk-producing breast tissue has been removed.

However, one healthy breast can often produce enough milk to breastfeed a baby successfully.

Women who have previously undergone breast cancer treatment and are planning pregnancy or breastfeeding should discuss their individual situation with their breast surgeon, obstetrician and lactation specialist.

What About Breastfeeding During Cancer Treatment?

This is different from breastfeeding after cancer treatment has been completed.

Several anticancer medications can pass into breast milk and potentially harm a nursing infant. Breastfeeding is therefore generally avoided during many forms of systemic cancer treatment, including chemotherapy and certain targeted, immunotherapy and endocrine treatments.

Recommendations vary according to the specific drug being used.

A woman undergoing cancer treatment should therefore not decide to continue or stop breastfeeding without discussing it with her oncology team.

Does Breastfeeding Make It Harder to Detect Breast Cancer?

Breastfeeding does not prevent breast cancer from being diagnosed, but the natural changes occurring in the breast during lactation can sometimes make abnormalities less obvious.

This is why awareness is more useful than fear.

There is no need for a breastfeeding woman to examine her breasts looking for cancer repeatedly. Instead, she should become familiar with how her breasts normally feel during lactation.

A new, persistent or progressively changing abnormality deserves medical attention.

Breastfeeding With Confidence — While Staying Breast Aware

Breastfeeding offers important benefits to both mother and baby and is associated with a reduction in breast cancer risk.

At the same time, motherhood is often a time when women put their own health behind their baby’s needs.

A breast lump during breastfeeding is usually benign. But if it persists, enlarges or behaves differently from a typical blocked duct or infection, it deserves evaluation.

Ultrasound, mammography and breast biopsy can all be performed when medically necessary during lactation.

The message is therefore simple:

Breastfeed with confidence. Stay breast aware. And never postpone the evaluation of a persistent breast change simply because you are breastfeeding.

About Dr Ajesh Raj Saksena

Dr Ajesh Raj Saksena is a Surgical Oncologist in Hyderabad with expertise in breast cancer surgery and comprehensive surgical oncology. His clinical practice includes the evaluation and surgical management of breast cancer, with an emphasis on appropriate diagnosis, evidence-based treatment and multidisciplinary cancer care.

Women with a persistent breast lump, nipple or skin changes, or other concerning breast symptoms should seek assessment from a qualified breast specialist or surgical oncologist.