Breast Department, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Int Breastfeed J. 2024 Jun 5;19(1):41. doi: 10.1186/s13006-024-00647-8.
Surgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women's ability to breastfeed. There are only a few studies describing the experience of breastfeeding in women who have undergone benign breast disease (BBD) surgery.
We retrospectively analysed data from patients aged 20-40 years in Guangdong, China, who underwent breast lumpectomy for BBD in our department between 01 January 2013 and 30 June 2019, with a follow-up date of 01 February 2022. Patients were included who had a history of childbirth between the time of surgery and the follow-up date. By collecting general information about this group of patients and information about breastfeeding after surgery, we described the breastfeeding outcomes of women of a fertile age who had previously undergone surgery for benign breast disease.
With a median follow-up of 5.9 years, a total of 333 patients met the inclusion criteria. From the breastfeeding data of the first child born postoperatively, the mean duration of 'exclusive breastfeeding' was 5.1 months, and the mean duration of 'any breastfeeding' was 8.8 months. The rate of 'ever breastfeeding' is 91.0%, which is lower than the national average of 93.7%, while the exclusive breastfeeding rate at six months was 40.8%, was higher than the 29.2% national average. The any breastfeeding rate at 12 months was 30.0%, which was well below the 66.5% national average. The common reason for early breastfeeding cessation was insufficient breast milk. A total of 29.0% of patients who had ever breastfed after surgery voluntarily reduced the frequency and duration of breastfeeding on the operated breast because of the surgery.
There are some impacts of BBD surgery on breastfeeding and some may be psychological. Institutions should provide more facilities for mothers who have undergone breast surgery to help them breastfeed, such as conducting community education on breastfeeding after breast surgery, training professional postoperative lactation consultants in hospitals, and extending maternity leave. Families should encourage mothers to breastfeed with both breasts instead of only the non-operated breast.
手术是治疗良性乳腺疾病的主要方法，即使这种干扰是局部的，也会对乳房的正常生理功能造成一定的破坏，目前仍不清楚它是否会影响女性的哺乳能力。仅有少数研究描述了接受良性乳腺疾病（BBD）手术的女性的母乳喂养体验。
我们回顾性分析了 2013 年 1 月 1 日至 2019 年 6 月 30 日期间在我科因 BBD 接受乳房肿块切除术的年龄在 20-40 岁的中国广东患者的数据，随访日期为 2022 年 2 月 1 日。纳入标准为手术至随访日期之间有分娩史的患者。通过收集这组患者的一般信息和手术后母乳喂养的信息，我们描述了既往接受良性乳腺疾病手术的育龄妇女的母乳喂养结局。
中位随访时间为 5.9 年，共有 333 名患者符合纳入标准。根据术后第一胎的母乳喂养数据，“纯母乳喂养”的平均持续时间为 5.1 个月，“任何形式母乳喂养”的平均持续时间为 8.8 个月。“曾母乳喂养”的比例为 91.0%，低于全国平均水平 93.7%，而 6 个月时的纯母乳喂养率为 40.8%，高于全国平均水平 29.2%。12 个月时的任何形式母乳喂养率为 30.0%，远低于全国平均水平 66.5%。早期母乳喂养停止的常见原因是母乳不足。共有 29.0%的术后曾母乳喂养的患者因手术而自愿减少了对手术乳房的哺乳频率和时间。
BBD 手术对母乳喂养有一定的影响，其中一些影响可能是心理因素造成的。医疗机构应为接受过乳房手术的母亲提供更多的母乳喂养设施，如开展乳房手术后母乳喂养的社区教育、在医院培训专业的术后哺乳顾问、延长产假等。家庭应鼓励母亲用双侧乳房进行母乳喂养，而不仅仅是未手术的乳房。
