Breast Cancer Treatment During Pregnancy
Read our blogs:
- I Was 17 Weeks Pregnant When I Learned I Had Breast Cancer
- Kate’s Story: Was I Going to Die? Was My Baby?
How is breast cancer found in pregnant women?
Most breast cancers in pregnant women are found when a woman notices a lump or change in her breast, or during a clinical breast exam. Pregnant women may get a clinical breast exam as part of their prenatal care.
Women under 40 usually don’t get screening mammography unless they have an increased risk of breast cancer. Screening mammography may be used in pregnant women and women who are breastfeeding [330] However, their mammograms can be hard to read due to changes in the breast tissue during pregnancy and breastfeeding [330]. So, for women over 40 at average risk of breast cancer, screening mammography is usually delayed until after women give birth and finish breastfeeding.
Follow-up tests if a change or lump is found
If a lump or other change is found, a pregnant woman may have a diagnostic mammogram (with digital breast tomosynthesis) and/or a breast ultrasound to check for breast cancer.
Breast MRI is not used during pregnancy [9]. The contrast agent, gadolinium, used in breast MRI may be harmful to a fetus [9].
Stage at diagnosis
Breast cancer can be hard to detect in [227]:
- Pregnant women
- Women who have just given birth
- Women who are breastfeeding
The increased size and change in the texture of the breasts can make small lumps hard to feel.
This can delay diagnosis [227]. So, breast cancers in pregnant women may be diagnosed at a later stage than in non-pregnant women [227].
Treatment
Although cancer itself doesn’t affect the fetus, some breast cancer treatments can be harmful [10].
Your treatment plan and the timing of your treatments are chosen to treat your cancer as well as protect the fetus.
Surgery and radiation therapy
Breast surgery is safe during pregnancy.
Although the anesthesia used during surgery can cross the placenta to the fetus, it doesn’t appear to cause birth defects or serious pregnancy problems [228].
Breast reconstruction, however, should be delayed until after the baby is born to avoid further anesthesia and the chance for blood loss.
Radiation therapy is needed after a lumpectomy, but radiation can harm the fetus. So, a mastectomy (instead of a lumpectomy) is usually recommended for pregnant women who are in their first trimester and want to continue their pregnancy [10,228].
Some women in their second or third trimester may consider a lumpectomy [10]. In these cases, radiation therapy is delayed until after the baby is born. This delay doesn’t affect chances for survival [10].
Some women in their second or third trimester may have neoadjuvant chemotherapy (chemotherapy before surgery) [10].
Chemotherapy
Chemotherapy is not given during the first trimester [10,227-229]. The first trimester is when the chances for drug-related birth defects and miscarriage are greatest [227-229].
During the second and third trimesters, some chemotherapy drugs can be used safely [10].
However, chemotherapy should not be given after week 35 of pregnancy or within 3 weeks of the due date (or planned delivery date) [10]. This gives a woman time to recover from chemotherapy before delivery.
Many women diagnosed in their third trimester wait until after giving birth to have chemotherapy.
Other drug therapies
Other drug therapies for breast cancer treatment, including hormone therapy and HER2-targeted therapy, are not used at any point during pregnancy because of risks to the fetus [10,139,157,161].
Survival
The chances of survival for pregnant women with breast cancer are similar to the chances of survival for non-pregnant women of the same age and cancer stage [230-231].
Ending a pregnancy doesn’t improve survival [230-231].
Gina Samet, survivor & mother
“I was diagnosed with breast cancer, and I was 6 months pregnant with my first child. There is hope.”
Breastfeeding after a breast cancer diagnosis
If you’ve been diagnosed with breast cancer and wish to breastfeed, talk with your health care provider.
Breastfeeding should be avoided while being treated with radiation therapy, chemotherapy or other breast cancer drug therapies, including hormone therapy and HER2-targeted therapy [10,139,157,161].
Surgery and radiation therapy may make it difficult to nurse from the treated breast.
Support
Social support is important for young women diagnosed with breast cancer. It’s also important for loved ones, especially spouses, partners and children.
Learn more about social support for young women diagnosed with breast cancer.
Learn more about social support for spouses, partners and other family members.
Susan G. Komen® Support Resources |
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Updated 06/07/24
