'I Breastfed Two Babies After Breast Cancer' -- One Mom's Story

Breastfeeding can be hard work ... but breastfeeding after breast cancer is another level of difficulty entirely. Just ask Patty Evans, a 36-year-old mom of two who lives with her husband, Chuck, and their two kids in rural Bangor, Pennsylvania. Before being diagnosed with breast cancer at the age of 28, the mother of 22-month-old daughter Darby and 6-month-old son Marlin had a vastly different life.

She was single and logging long hours as a financial analyst at a private equity firm near Philadelphia. Yet once she felt a lump in her right breast and learned she had stage II breast cancer, she knew that if she got through this alive, she'd want a job where she could help others (her oncologist, founder of BreastCancer.org, ended up hiring her as VP of finance for her nonprofit) and a slower pace of life so she could try to have a family. Even then she knew she wanted to breastfeed her kids.


"While I was open to using formula, I knew I'd want all the health benefits of breastfeeding for my baby, like the boost to their immunity," Evans recalls. "I also just felt that breastfeeding was something that as a woman you're capable of doing, so it's something I should at least try."

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Yet very few breast cancer survivors ever manage to breastfeed: although no statistics exist on the percent who succeed, the very treatments they face make the odds seem pretty grim.

"Clearly, if you have a mastectomy, you can't breastfeed on that side, and this is often true with lumpectomies as well," Evans explains. "Meanwhile radiation destroys breast tissue. Women can't breastfeed while on Tamoxifen, which is typically taken for five years. It's also hard to get a proper mammogram while pregnant or breastfeeding, since your breasts become so dense. So you also have to delay screening as well, which can be dangerous."

Yet in spite of these hurdles and risks, Evans prevailed at breastfeeding both of her kids. Here's how she pulled it off, and the surprising benefits she reaped as a result.

What was it like for you to be diagnosed with breast cancer at 28? It must have been such a shock!
Completely. Breast cancer runs in my family so I always knew it was a possibility, but I figured it would happen down the line in my 50s, after I'd had a family. But at 28, I was dating a man but not yet engaged -- although he did hang in there and became my husband when I was 30. Next to my own survival, my biggest concern was that my cancer treatment could dampen my fertility and odds of conceiving. So I decided to freeze my eggs -- that way, if all went well, I could have them fertilized and implanted later when I was ready to have kids.

So how did your desire to have kids and breastfeed impact your treatment decisions?
The cancer was in my right breast and stage II, which meant it was contained within the breast and hadn't spread beyond that. Getting a mastectomy would have been the safest option for me, but I decided to get a lumpectomy instead, just to leave open the possibility of breastfeeding on that breast. It was a tough decision. My survival was of course the number one priority, but since I wanted to one day have a family, I wanted to leave open the option to breastfeed. And it turned out that in my case at least, the survival rates for a lumpectomy and mastectomy were equivalent enough. So I got a lumpectomy, followed by chemo, radiation on the right breast, and then the hormonal treatment tamoxifen for three years.

So did your breast cancer treatment impact your fertility?
Apparently not! Soon after my radiation treatments were over, my periods resumed, and I got pregnant naturally at the age of 33, without frozen eggs.

Wow! So how did your doctors feel about you breastfeeding?
All were very supportive. They said it would be good for my baby and also good for me, since new research suggests that breastfeeding can lower the odds of developing breast cancer by upwards of 10 percent. That said, my oncologist did make me aware that while I was pregnant and breastfeeding, I'd have to delay getting my yearly mammogram. I felt that would be OK since my goal was only to breastfeed for a few months, so combined with pregnancy that would mean I was only delaying my annual screening for a few months as well.

So how easy was breastfeeding for you at the beginning?
During my pregnancy and especially after the birth of our daughter Darby, I noticed that my left breast was swelling and leaking, but my right breast seemed dormant. When I tried to breastfeed or pump on that side, nothing came out. Apparently the cancer treatment had damaged the milk ducts in my right breast enough that it couldn't produce milk. So if I was going to breastfeed, it would all be up to my left breast to produce enough milk.

That sounds challenging! What did you do to boost your supply on that one side?
I pumped a lot, took fenugreek, drank tons of "mother's milk" herbal tea, and stayed really hydrated. I went on discussions boards online and read threads from cancer survivors about breastfeeding. Some were having great success -- after all, if a mom can nurse twins with two breasts, a mom can nurse one child with one -- but some women were still struggling. But overall, I'd say I encountered a lot of the same breastfeeding challenges as moms with two breasts, only it was worse since it was all on one side! My left nipple took a lot of wear and tear, and I couldn't switch.

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Ouch! How did you cope?
A nipple shield helped with the pain, as did steroid cream. But in the end, the doctors said that my daughter's urine looked concentrated and advised that I supplement with formula. That definitely took a bit of the pressure and anxiety off me so I could just enjoy the breastfeeding I could do.

So what was the experience of breastfeeding like, after all you'd been through?
It was kind of like everything had come full circle. I'd had this huge life crisis at a young age, but still managed to survive, get married, have kids, and breastfeed them. It was so worth it. I managed to nurse my daughter for three months. The one thing was since I had to delay my yearly mammogram, it was certainly nerve-wracking to wonder what was growing in there undetected.

The very day I stopped breastfeeding, I called to schedule my mammogram, which thankfully was clear. Once my son was born, I decided to breastfeed him too. Sure, it was challenging, but my daughter was thriving, so I wanted to have that same opportunity with him too.

Were there any other challenges you faced breastfeeding after breast cancer?
One funny thing was that I had very different sized breasts: my right was an A-cup, while my left was a C or D. So I got a silicone cookie to place on my right side to even them out. I also told myself, "Hey, you beat breast cancer and are lucky enough to have a family." When you do that, how you look becomes a lot less important.

What advice do you have for other women with breast cancer who may want to breastfeed later on?
Put your own health first. You have to make the best decision regarding surgery and treatment to protect your own life first and foremost. But if having a family and breastfeeding are important to you, women should know it is usually possible to have that, too. It's a balance. But also know that breastfeeding is good for you too, lowering the risk of breast cancer. So it's nice to know that by breastfeeding, you're doing something good for both for you and and your kids.

What obstacles did you have to overcome to breastfeed?


Image via Patty Evans

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