Carboplatin and breastfeeding

[Tuuli]

Hi!

I'm a TNBC patient and have received Carboplatin during my first rounds of chemo in spring and summer 2022 (last dose in June). After that I've received other treatments and also more rounds of chemo (but no more carboplatin).

I stopped breastfeeding my children when the chemo started. Now, a year later, I'm finally done with all the treatments. My question is, if it will ever be safe to continue breastfeeding again? The most complicated drug is carboplatin, because it's not possible to measure the platinum level of the milk in my home country. Is it possible to estimate, how many months should you wait after the last dose, if you can't measure the platinum level?

[kaytlin]

Hi Tuuli,

Drug residues in breast milk are always a game of risk versus benefit - of treatment, of the absence/presence of breastfeeding, and considering both infant and mother. For carboplatin, the standard recommendation is to stop breastfeeding at that time; breastfeeding may be resumed with the delivery of the next infant. Platinum is known to stick around for decades after therapy at low levels. However, the first few months of breastmilk would likely outweigh the risk of long-term platinum residues in a child exposed to higher levels in utero. This maximizes the potential benefit to the baby and mother and limits added risk to the family as a whole.

Congratulations on finishing treatments!
Kaytlin Krutsch, PharmD