I have a patient with papillary thyroid cancer with nodal metastasis. She was diagnosed when she was pregnant at 2 months. One month postpartum, she underwent total thyroidectomy, and is being evaluted for radioblation with suppressive therapy. She is currently breast feeding, and intends to breast feed her now 2 months old child. How soon after radioablation, she can restart breast feeding her baby, if at all? Will appreciate your reply.
Hiralal Maheshwari, MD, PhD, Crystal Lake, IL
A possibility of course is to suppress TSH now and treat with 131I after breastfeeding has been discontinued. This is what I would prefer, as any contamination of the newborn with 131I should be avoided, which means a difficult situation for handling the child by the mother anyway for several weeks after the treatment. To my opinion no harm is done to wait with 131I for a few months, provided that TSH is suppressed.
Georg Hennemann, MD, PhD, FRCP, FRCPE