Join our newsletter
Get updated info, tips and news about breastfeeding, e-lactancia project and other initiatives from APILAM
Legitimation: Consent of the interested party
As a user and interested I inform you that the data you provide will be located on the servers of MailChimp (email marketing provider of APILAM) outside the EU in the USA. MailChimp is covered by the EU-US Privacy Shield agreement, whose information is available here, approved by the European Committee for Data Protection. See Mailchimp's privacy policy. (https://mailchimp.com/legal/privacy/).
The fact that you do not enter the personal data that appear on the form as mandatory may have the consequence that we can not meet your request.
You can exercise your rights of access, rectification, limitation and delete the data in apilam.es@gmail.com as well as the right to file a claim with a control authority.
You can consult the additional and detailed information on Data Protection on this website: http://e-lactancia.org, as well as consult our own privacy policy.
An antineoplastic similar to busulfan with alkylating action.
Indicated in the treatment of ovarian cancer, administered orally, daily dose (in cycles of 2 to 4 weeks with the same resting time or 1 week with 3 weeks rest), intravenously (in cycles with 1 to 3 weeks of rest) and intraperitoneally.
Since the last update date we have not found published data on its excretion in breastmilk.
Pharmacokinetics show that after 3 elimination half-lives (T½) 87.5% of the drug is eliminated from the body; after 4 T½ it is 94%, after 5 T½, 96.9%, after 6 T½, 98.4% and after 7 T½ it is 99%. From 7 T½ the plasmatic concentrations of drug in the body are negligible. In general, a period of at least five half-lives can be considered a safe waiting period before breastfeeding again (Anderson 2016).
Taking the longest published T½ of all the active metabolites as a reference (Romanski 2018), these 5 T½ would correspond to 11 hours. Due to major side effects, it would be advisable to wait 7 T½, which would correspond to 15 hours. Meanwhile, express and discard milk from the breast regularly to maintain production.
When it is possible to do so, milk detections of each patient to determine the total elimination of the drug would be the best indicator to resume breastfeeding between two cycles of chemotherapy.
During breast cancer treatment, breastfeeding must be interrupted due to potentially serious side effects for the infant. Chemotherapy does not affect milk production during or after treatment. Abrupt weaning can be psychologically traumatic for both the mother and the infant (Pistilli 2013). If the mother wishes, the production of milk can be maintained by regularly expressing milk from the breast, being able to return to breastfeeding in the periods in which no significant traces of the drug remain in the milk (Anderson 2016) or at the end of the treatment (Pistilli 2013).
Some chemotherapeutic agents with an antibiotic effect can alter the composition of the microbiota (bacterial set or bacterial flora) of the milk and the concentration of some of its components (Urbaniak 2014). This possibly occurs temporarily with subsequent recovery, although no harmful effects are assumed or have been reported in breastfed infants.
Women undergoing chemotherapy during pregnancy have lower rates of breastfeeding due to difficulties in breastfeeding (Stopenski 2017), needing more support to achieve it.
Given the strong evidence that exists regarding the benefits of breastfeeding for the development of babies and the health of mothers, it is advisable to evaluate the risk-benefit of any maternal treatment, including chemotherapy, individually advising each mother who wishes to continue with breastfeeding (Koren 2013).