Breastfeeding After Mastectomy: Katie Benson

Written By Robin Warshaw, Contributing Writer

As a teenager, Katie Benson was told she would have trouble getting pregnant. She had endometriosis, a condition in which cells from the lining of the uterus travel and grow elsewhere. Endometriosis causes pain, cramping and, often, infertility.

“The doctor told me if I didn’t get pregnant by 30, it wouldn’t happen,” she says.

Fast-forward to Katie at age 31, living in Winterville, North Carolina. She and her husband had been trying for a pregnancy, with no success.

Then a pain in her breast sent Katie to the doctor. Testing showed she had ductal carcinoma in situ, or DCIS, in her left breast. Although noninvasive, DCIS can become invasive breast cancer.

The DCIS grew from 3 centimeters at diagnosis to 6 centimeters when she had surgery three weeks later. Her doctor recommended a single mastectomy due to the size and location of the tumor. She had no other treatment.

Afterwards, her first question was, “Am I cleared to get pregnant?” Her surgeon and oncologist told her to go for it.

Pregnancy Challenges

Four months later, Katie was pregnant. “When I actually saw the little home test [showing she was pregnant], it was such a shock!” she says.

The next shock was even greater. At her first ultrasound, she looked at the screen and saw two rib cages. She was having twins.

Everything went smoothly until week 34 of the usual 40-week pregnancy. Lab tests showed Katie had preeclampsia, a complication of pregnancy that causes high blood pressure. Often, women with preeclampsia are forced to deliver the baby early. She also had HELLP syndrome, a dangerous condition in pregnancy that can cause stroke and death.

Katie was immediately hospitalized. When she realized the early delivery meant the babies would be born on the one-year anniversary of her DCIS diagnosis, she begged doctors to delay. “I was very upset,” she says. “I thought they [the twins] would be marked by cancer.”

The birth was not delayed and went safely for mother and infants, a girl and boy delivered by Caesarean section. As they recovered in the hospital, there was much more to think about. Katie wanted to breastfeed. But because of her mastectomy, she faced another challenge: Two babies. One breast.

Even women with two breasts find it challenging to nurse twins. Each baby needs to be fed from 7 to 12 times a day, depending on age, which can be hard on the mother’s breasts. Her one breast was going to have to work hard.

Adapting to Breastfeeding

Before she knew she was having twins, Katie worried about how to breastfeed with only one breast. In general, women with two breasts alternate sides during feedings, to reduce wear-and-tear on the nipples and help both breasts to keep producing milk.

Katie’s concern multiplied when she learned there would be two babies. Then a good friend reassured her. No one could expect her to breastfeed two babies perfectly. “Just do the best you can,” her friend said. Those words comforted Katie.

She rented a hospital-grade pump to get as much milk from her one breast as possible. The babies started on three-quarters breast milk and one-quarter formula.

Even with the better pump it wasn’t easy. “For one thing, it hurt like nothing else because everything had to come from that nipple,” Katie says. She struggled with the awkwardness of being right-handed and feeding only from the right breast. Because she and her husband worked opposite shifts, she often had one baby at her breast and one in her lap, with a bottle.

She went back to work when the babies were 7 weeks old, but pumped there as well as at home. She was determined to give the babies the health benefits of her breast milk, in part because she felt guilty about them having been born early. Breastfeeding, she says, was “something I [could] provide for them.’”

Sorting It Out

Katie, now 34, remembers the stress she felt about breastfeeding and how she accepted what was possible. Instead of aiming for the “exclusively breastfeeding” standard that many women feel pressured to achieve, Katie told people she was “inclusively breastfeeding.” That phrase, to her, avoided “all the strife” that nursing can pose for new moms. Even for those with two breasts.

“Breastfeeding is so rocked with all these emotions. The nice thing about breastfeeding after mastectomy is…I wanted to give it my best, but [knew], no matter what, I’m gonna have to do formula,” she says.

The twins are now 2 years old and thriving. As time passed, Katie began to see the timing of their birth and her 1-year “cancerversary” not as a bad sign, but as a way of showing things could become better.

“It was incredible that I had never gotten pregnant before, but that after this diagnosis I did,” she says. “I prayed for a miracle and I got two.”

This article was supported by the Grant or Cooperative Agreement Number 1 U58 DP005403, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.