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I will be having I-131 ablation treatment for thyroid cancer when my youngest is 12 months old. I am planning to relactate and am looking into testing options to quantify the radioactivity in my breastmilk. I have been told that while local hospitals have gamma radiation counters, they aren’t specific enough for breastmilk. Any idea as to what is available?
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Hi Kateviz,
We haven't had any luck finding a labs that will do this commercially. You may reach out to large univeristy research centers nearby. It requires specialized equipment that is uncommon. If you find someone who can do it, don't forget to ask how long it would take to receive results. If it takes a month after you provide the sample, it will be less helpful for your purposes.
Full disclosure: you've got an uphill battle ahead. For your case, I expect you will be asked to stop breastfeeding at least a month prior to the procedure. The lactating breast pumps iodine into milk activly, and gets about the same dose of I-131 as your thyroid. Therefore, the goal is to allow your breast to return to as close to a non-lactating normal as possible prior to the treatment. The wait will to prevent I-131 from accumulating in and damaging your breast. After the procedure, the standard recommendation is to wait for 5 half-lives to minimize infant exposure to radiation. The half-life of I-131 is ~8 days, which would mean at least a 40-day wait after the dose. Together, this will be more than 2 months abstaining from breastfeeding. As your infant will be older at that point, re-lactation may prove challenging.
This is a challenging situation, and I'm sure these are not the answers you were hoping for. Be sure to have a thorough conversation with your healthcare providers about contact restrictions with your children after the procedure as well. It is no fun, but necessary to keep everyone safe and healthy.
Kaytlin Krutsch, PharmD
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