1. Pink Ribbon Days: A Personal Journey
Through Breast Cancer
On October 15, 2004, I was diagnosed with breast cancer. I was 43 years old, had no family history of the
disease, and no lump or symptoms. I was also tandem nursing my two young children.
The cancer was discovered during my first routine mammogram. Mammograms (a procedure that uses low-dose x-
rays to examine the breasts) are recommended annually for women over the age of 40, and a baseline mammogram
is recommended at age 35. Although I was over 40, I had delayed this initial mammogram because I was pregnant,
and delayed it again because I was breastfeeding – a potentially life-threatening mistake. When the radiologist
examined my mammogram, he noted a small cluster of microcalcifications in my left breast, a half-dozen white
flecks that looked like grains of salt sprinkled over the image. These microcalcifications were an indicator of Duc-
tal Carcinoma in Situ (DCIS) - a non-invasive breast cancer where the malignant cells in the milk ducts have not
yet invaded the surrounding tissue. The next day I had a core biopsy, where a section of breast tissue was removed
to determine if the cells were indeed cancerous. Two days later the radiologist called with bad news: the tissue
removed confirmed the presence of DCIS. My next step was to see a surgeon.
The first surgeon I saw began by discussing mastectomy, the surgical re-
moval of the breast. Although DCIS is non-invasive, it is considered a risk
factor for developing invasive breast cancer and is therefore usually treated
aggressively. I sought a second opinion and consulted a breast surgeon at a
different hospital. She recommended immediate weaning from both
breasts prior to surgery, advising that it would be impossible for me to stop
nursing only on the affected side. I knew this to be incorrect: women can
(and do) breastfeed on only one side. A third opinion from the surgical
oncologist who had supervised my original biopsy recommended a partial
mastectomy (essentially a “lumpectomy,” where only the affected area and
a small margin of healthy tissue is removed, except that I had no lump)
without weaning, followed by radiation to make sure that all of the cancer
cells were destroyed. Removal of lymph nodes and chemotherapy were
not necessary as the cancer was not invasive and therefore there was virtu-
ally no possibility of its spread to any other part of my body.
In November I had a partial mastectomy of the left breast. As I had after the biopsy, and with my doctors’ bless-
ing, I was able to nurse my 22-month-old son within 12 hours after surgery. Six weeks later I began Intensity
Modulated Radiation Therapy (IMRT), an advanced mode of high-precision radiation therapy that uses computer-
controlled x-ray accelerators to deliver precise radiation doses to specific areas. My treatments were scheduled
five days a week for 6-1/2 weeks. Although the IMRT itself was painless, I suffered some common side effects:
extreme fatigue and “sunburned” patches of skin. But with the approval of my radiation oncologist, and the help of
friends and family, I continued caring for my children and breastfeeding until radiation burns to my nipple forced
me to wean on the treated side. I have continued nursing on my right breast.
I completed radiation therapy around Valentine’s Day, 2005. Since I am now considered at higher risk of develop-
ing another breast cancer, I see my surgical oncologist for a breast exam every three months and have a mammo-
gram every six months. I also see a medical oncologist, who will continue to monitor my health for the rest of my
life. Because my cancer was ER+ (estrogen receptor positive), after we stop breastfeeding I will take tamoxifen, a
medication that blocks the estrogen receptors on the breast cells and deprives the potentially malignant cells of the
estrogen they need for growth. Tamoxifen, a pill which is usually taken for 5 years, decreases the incidence of
(Continued on page 3)
Inside this issue:
Pink Ribbon Days 1,3
Garage Sale 2
October: Breast Cancer
Awareness Month
2
October Events 3
Protective Effects of
Breastfeeding
4
Announcements and
Thanks
5
This newsletter is produced
every two months. Contribu-
tions are welcome. Next edi-
tion will be November/
December.
Please send articles, book
reviews, quotes, questions
and answers, recipes, birth
stories, weaning stories, po-
ems, etc. to:
mblando@comcast.net
September/October
2005
Issue 15
LA LECHE LEAGUE OF DALLAS
Breastfeeding Information and Support

2. BREAST CANCER FACTS AND FIGURES
• Breast cancer is the most common cancer among American women.
• Breast cancer is the second-leading cause of cancer death in women after lung cancer --
and is the leading cause of cancer death among women ages 35 to 54.
• One in four new breast cancer cases occurs in women of childbearing age.
• Approximately 3-7% of all breast cancer diagnoses take place in women who are preg-
nant or breastfeeding.
• Mammography helps detect breast cancers because it can show changes in the breast up
to two years before a patient or physician can feel them. (American College of Radiology)
• Mammograms have been shown to lower the chance of dying from breast cancer by 35%
in women over the age of 50, and by 25–35% for women between 40 and 50.
TIPS FOR NURSING MOTHERS
• You don’t have to wait until you’ve weaned to have a mammogram or other breast imag-
ing technique.
• Ask for a digital mammogram: recent studies have shown that digital mammography is
significantly more accurate than film mammography at detecting cancer in women under
50 years of age, women with dense breasts, and premenopausal women.
• If possible, schedule your mammogram or MRI during the follicular stage of your men-
strual cycle (the time period occurring between menstruation and ovulation) when your
breasts are less dense and therefore easier to image.
Garage Sale
October: Breast Cancer Awareness Month
Page 2 LA LECHE LEAGUE OF DALLAS
October 27 and 28
8 am - 4 pm
11247 Lanewood Circle
Dallas, TX
Come shop our huge selection of gently
used baby and children’s clothing, baby
equipment, toys, adult clothes and
household items.
The garage sale is our group’s largest
source of income each year and all pro-
ceeds benefit LLL of Dallas.
Thank you Jen Widhelm for volunteer-
ing your house for the garage sale.
We Need Your Help!
Please Donate
We need clothing (all sizes), baby equipment and household items. You are welcome to
sell your own items but you must be present for all sales and we ask that you donate a
portion of your proceeds to LLL Dallas. Drop-off is Tuesday, October 25 (4 pm - 8
pm) or Wednesday, October 26 (before noon) at 11247 Lanewood Circle.
Please Help Sort and Tag
We will have a sorting party on Wednesday, October 26, starting at 9 am. We need
hangers, folding tables, hanging racks and helpers. All helpers may buy any items dur-
ing the sorting process, so come, drop off your items and stick around to help sort and
enjoy first dibs on everything.
Please Help Work the Sale
We need workers both days from 7:30 am - 4:30 pm. We especially need help with set
up and tear down both days.
In a large international study,
the risk of breast cancer was
reduced by 7.0% for each
birth (live or stillbirth).
Breastfeeding further reduced
the risk: women who had a
cumulative total of 12 months
of breastfeeding had a 4.3%
decrease in the relative risk of
breast cancer, and women who
had a cumulative total of 55
months or more decreased
their risk by 27%.
From Collaborative Group on Hormonal Factors in
Breast Cancer. Breast cancer and breastfeeding:
collaborative reanalysis of individual data from 47
epidemiological studies in 30 countries, including
50,302 women with breast cancer and 96,973
women without the disease. Lancet 2002; 360:
1887-95.

3. subsequent breast cancer in both breasts, and can be used both before and after menopause.
Although I was aware of breast cancer before my diagnosis, I never thought it would happen to me. I was healthy, active, never smoked, rarely drank,
and had breastfed for four years – all things I knew reduced the risk of cancer. But breast cancer is mysterious: most women with the disease have no
family history of the condition and no identifiable risk factors. Yet increasing numbers of women are being diagnosed with breast cancer due to a com-
bination of having children later in life (a known risk factor), reduced rates of breastfeeding, and improved screening techniques (such as digital mam-
mography). Women can protect themselves by having regular breast exams by a healthcare professional and by having mammograms according to the
recommended schedule - even while lactating. You can also decrease your chances of developing breast cancer by continuing to breastfeed: although
the exact mechanism of protection is unclear, studies have shown that the longer a woman breastfeeds throughout her lifetime, the greater the protective
effect.
I am fortunate that my breast cancer was detected very early and that I have an excellent prognosis. I have continued to breastfeed and sought physi-
cians who were sensitive to my desire to preserve the function, as well as the form, of my breasts. Breastfeeding through this turbulent time brought a
sense of normalcy to my life and that of my children, and in doing so I have also served as an example to my healthcare team. They now know that the
ability to breastfeed, something with enormous health and psychological benefits for both mother and child, can be preserved and continued for many
women with early stage breast cancer.
Carole Baas, Ph.D., is a medical researcher, writer, and lecturer, specializing in health and parenting issues. Following her breast cancer diagnosis, she began researching the rela-
tionships between pregnancy, breastfeeding and breast cancer. Carole is currently spearheading efforts to write the first book on this subject, Battle for the Breast, a cooperative effort
between internationally renowned researchers and clinicians in breast cancer, infertility, and lactation.
Photo of Carole and her son, Darayus, by Stacy Dail Bratton, SD/SK Studio, Inc., Dallas, TX (www.stacybratton.com/).
Playgroup
Every Friday 10:30 am
Lake Highlands North Recreation
Center
9401 White Rock Trail (Near Skill-
man and Church)
Dallas
At the playground, weather permit-
ting, otherwise indoors.
Series Meeting
First Thursday 7:30 pm
Presbyterian Hospital of Dallas
8200 Walnut Hill Lane
Dallas
Margot Perot Building Lower Level
(LL) Conference Room
Near DART Station on Walnut Hill
Toddler Meeting
Fourth Tuesday 10:00 am
Greenland Hills United Methodist
Church
5830 Penrose
Dallas
Off Greenville, between Skillman and
Matilda; south of Mockingbird
Pink Ribbon Days (continued)
Page 3Issue 15
6 Series Meeting Bringing the Baby Home, 7:30 pm
7 Playgroup 10:30 am
14 Playgroup 10:30 am
21 Playgroup 10:30 am
25 Toddler Meeting Attachment Parenting: Help Your Child Develop Confi-
dence and Move Towards Independence, 10:00 am
26 Garage Sale Sorting Party 9:00 am
27 Garage Sale 8:00 am – 4:00 pm
October 2005 Events
28 Garage Sale
Playgroup
8:00 am – 4:00 pm
10:30 am
“One mammogram exposes a woman to roughly the same
amount of radiation as flying from New York to California
on a commercial jet.” (American Cancer Society)

4. The Protective Effects of Breastfeeding against Breast Cancer
By Carole Baas
Page 4 LA LECHE LEAGUE OF DALLAS
Breastfeeding has been shown in numerous studies to have a protective effect against breast cancer (1). Exactly how this occurs, however, is un-
clear.
Human breast tissue begins to develop by the sixth week of life. After this initial creation of breast tissue, the breast does not develop again until pu-
berty, when the tissue begins to grow and create the beginnings of ducts. Hormonal changes during this time further breast development, with the stem
cells becoming duct cells (which form the channels for milk flow) or lobular cells (the milk-producing cells). Estrogen causes the ductal tissue in the
breast to grow, and progesterone stimulates growth of lobular tissue (2). The cells are arranged in a complex branching pattern in which grape-like
clusters of cells (the lobules) connect with the ducts, and eventually open at the nipple. Each ductal system is independent of the others; each creates
milk separately. As in a tree, the branches coexist but do not interconnect.
A woman’s breast is not considered fully mature until she has given birth. During the first part of each pregnancy hormones cause the breast to grow
rapidly, followed by differentiation of breast tissue during the final months of pregnancy in preparation for milk production. As a result, the breasts of a
woman who has had a child contain a higher percentage of well-differentiated lobules than the breasts of a woman who has not given birth (3). After
delivery, estrogen and progesterone levels drop. Milk production begins as a result of another hormone: prolactin (4).
Prolactin levels decline in the months after birth, even as a woman’s body continues to produce milk. While a lactating woman’s prolactin levels are
still higher than those of a non-lactating woman and levels increase after each feeding, researchers believe that once breastfeeding is fully established,
milk production depends less on levels of prolactin in the mother’s
bloodstream and more on what is happening within the breast itself
(5).
Breast cancers are either responsive to estrogen (ER+) or unrespon-
sive (ER-). Cancer that is ER+ needs estrogen to grow. Breastfeed-
ing may reduce the risk of breast cancer indirectly by delaying the
re-establishment of ovulation (in which estrogen plays a critical
part), as women who breastfeed exclusively during the first six
months usually experience lactational amenorrhea – the absence of the menstrual cycle. The number of lifetime ovulations has been linked to breast
cancer risk, and researchers believe that extended periods of lactational amenorrhea may help explain the lower rates of ovarian, endometrial, and breast
cancer found in women who breastfeed (4,5).
Although the effect of lower estrogen levels during breastfeeding appears to lower the risk of breast cancer, this cannot be the only mechanism by which
breastfeeding protects. Estrogen levels do not stay lowered once ovulation has resumed, so some local effect within the breast itself must be triggered
by lactation. This was suggested by a study in which mothers who traditionally breastfed on only one side had significantly higher rates of cancer in the
unsuckled breast (6). Breastfeeding may also directly alter the hormonal milieu of the breast: breast fluid estrogen levels are suppressed for several
years after weaning (4,7).
Breastfeeding also reduces the concentration of carcinogens present in the ductal and lobular epithelial cells in the breast (8). This periodic “flushing”
of the ducts (which is where the majority of breast cancers start) may be another reason why breastfeeding has a protective effect against breast cancer.
Support for this theory comes when breastfeeding is correlated with the estrogen receptor status of the breast cancer. Results from a recent study indi-
cated that parity (which means that a woman has given birth) and age at first birth are associated with reduced risk of ER+ tumors only, while lactation
is associated with reduced risk of both ER+ and ER- tumors. This suggests that parity and lactation act through different mechanisms (9). Interestingly,
even women who carry the breast cancer gene mutation BRCA1 benefit from breastfeeding: a 2004 study found a 45% reduction in breast cancer in
women who breastfed for a year or more - an effect much greater than that seen in the general population (4). This is extremely important for these
women, as BRCA1 mutation carriers have up to 80% life-time risk of developing breast cancer (10).
(1) Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries,
including 50,302 women with breast cancer and 96,973 women without the disease. Lancet 2002; 360: 1887-95.
(2) Love, Susan M. Dr. Susan Love's Breast Book. (4th
Ed., 2005) Da Capo Lifelong Books: pp. 11-18.
(3) Russo J, Lynch H, Russo IH. Mammary gland architecture as a determining factor in the susceptibility of the human breast to cancer. Breast J 2001; 7: 278-91.
(4) Jernstrom H, Lubinski J, Lynch HT, et al. Breast-feeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. J Natl Cancer Inst. 2004 Jul 21;96(14):1094-8.
(5) La Leche League International. The Womanly Art of Breastfeeding. (7th
Revised Ed., 2004) La Leche League International: pp. 374-81.
(6) Ing R, Petrakis NL, Ho JH. Unilateral breast-feeding and breast cancer. Lancet. 1977 Jul 16;2(8029):124-7.
(7) Petrakis NL, Wrensch MR, Ernster VL, et al. Influence of pregnancy and lactation on serum and breast fluid estrogen levels: implications for breast cancer risk. Int J Cancer 1987; 40:587-
91.
(8) Riordan, Jan. Breastfeeding and Human Lactation (3rd
Ed., 2004). Jones & Bartlett Publishers: 819 pp.
(9) Ursin G. Reproductive factors and subtypes of breast cancer defined by hormone receptor and histology. Br J Cancer. 2005 Aug 8;93(3):364-71.
(10) Jernstrom H, Borg K, Olsson H. High follicular phase luteinizing hormone levels in young healthy BRCA1 mutation carriers: Implications for breast and ovarian cancer risk. Mol Genet
Metab. 2005 Aug 2; [Epub ahead of print].
(11) Woo JC, T Yu and TC Hurd. Breast Cancer in Pregnancy: A Literature Review. Arch Surg 2003; 138: 91-98.
Breast cancer during pregnancy and lactation is
expected to become increasingly common as women
delay childbearing until later in life, when the
incidence of breast cancer tends to rise (11)
.

5. WE’RE ON THE WEB!
http://home.swbell.net/barnes57/
Don’t Forget…
Tom Thumb Reward Card
La Leche League of Dallas is a
partner in the Tom Thumb Good
Neighbor Program. Stop by any
Tom Thumb, fill out a reward card
application and pick up your card.
Then give the cashier your reward
card and the number 581.
Your personal reward card will be
linked to LLL of Dallas. Every
time you shop and use your reward
card, Tom Thumb will send a per-
centage back to us as a donation.
A Special Thanks To…
New and Renewing Members
Stacie Widhelm, Becky Bales,
Kim Sierra, Lauri Houpy,
Arielle Richman, Grace Murphy,
Tania Loennekker, Tracey
Lindsey, Patti Howell and Sharon
Gardner
Group Workers
Newcomer Packets: Maureen Sweeny
Series Librarian: Grace Murphy
Series Snack Coordinator: Kim Sierra
Toddler Librarian: Juli Davidson
Yahoo Group Monitor: Barrie Glasscock
Newsletter: Monica Blando and Carole
Baas
Announcements…
Discover Babywearing
The practice of carrying your baby
in a soft carrier close to your body
while going about daily life.
Maria Blois, a La Leche League of
Dallas leader and author of the
new book, Babywearing, will be
offering her final workshop on Sat-
urday, October 15, from 10:30 am
to 12:30 pm at Destination Mater-
nity (5539 LBJ Freeway, near the
Galleria). This is a free seminar
with demonstrations of various
baby carriers and displays by area
carrier vendors, and offers a great
opportunity to learn the benefits of
w e a r i n g y o u r b a b y .
(www.drmariablois.com)
The La Leche League International (LLLI) mission is: To help
mothers worldwide to breastfeed through mother-to-mother sup-
port, encouragement, information, and education and to promote
a better understanding of breastfeeding as an important element
in the healthy development of the baby and mother.
LLLI reaches well over 300,000 people in 65 countries every
month and offers information in 32 languages. Currently ap-
proximately 7,200 accredited Leaders facilitate more than 3,000
monthly mother-to-mother breastfeeding support group meetings
around the world.
Your membership contribution helps defray the cost of mother-
to-mother help, including phone calls, printing, postage, bro-
chures, monthly meetings, etc. Annual membership is $40 and
includes a subscription to the bi-monthly publication New Begin-
nings and a discount on most items from the LLLI catalogue.
Please be sure to initiate and renew your membership through La
Leche League of Dallas so that our local group receives a portion
of the proceeds.
La Leche League of Dallas Leaders
• Gwen 214.320.9789
gwenfancy@sbcglobal.net
• Katie 214.351.9816
LLLkatie@swbell.net
• Vicky 972.235.6092
vsuarez@airmail.net
• Maria 214.321.1019
mgblois@aol.com
• Connie 214.520.0938
constanze@villinesfamily.com
Breastfeeding
Information and Support
Page 5