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Treating Breast Cancer During Pregnancy
If you are diagnosed with breast cancer while pregnant, you can still safely get treatment. There are also no reports showing that breast cancer itself can harm a baby.
Your treatment options will be more complicated, and the type and timing of your treatment will need to be planned carefully. But most studies have found survival rates are the same for pregnant and non-pregnant people whose breast cancers are at the same stage.
The extra concern of protecting a growing fetus can make treatment more complicated. But the goal will be the same: to cure the cancer whenever possible, or to control it and keep it from spreading if it cannot be cured.
Your cancer care team and your obstetrician (OB) will work together to coordinate your care.
On this page
- Is it safe to have breast cancer treatment during pregnancy?
- Breast cancer surgery during pregnancy
- Chemo and other treatments after surgery
- Treatments that usually wait until after delivery
- Can I breastfeed during cancer treatment?
- Does pregnancy affect survival rates for breast cancer?
- Having a baby after you finish treatment
Is it safe to have breast cancer treatment during pregnancy?
Yes. A pregnant person can safely get treatment for breast cancer, although the types and timing of treatment may need to be adjusted.
Your treatment plan will depend on:
- The size and location of your tumor
- Whether the cancer has spread, and if so, how far
- How far along you are in your pregnancy
- Your overall health
- Your personal preferences
Surgery: Surgery for breast cancer is generally considered safe during pregnancy, though timing may vary depending on the trimester. Your surgical team will help determine the best approach for your situation.
Chemotherapy: Chemo seems to be safe for the baby if it’s given in the second or third trimester of pregnancy. It is not safe in the first trimester.
Other treatments: Other breast cancer treatments such as hormone therapy, targeted therapy, antibody-drug conjugates (ADCs), immunotherapy, and radiation therapy are more likely to harm the baby. These are not usually given during pregnancy.
If there is a conflict between what is best for you and what is safest for the baby, a counselor or psychologist should be part of your care team to help with the emotional weight of these decisions.
Doctors do not routinely recommend ending a pregnancy to allow for cancer treatment.
Older studies found that doing so did not improve a person's outcomes. Although those studies had limitations, the overall evidence does not support ending a pregnancy as a standard approach.
This option may still be discussed in certain situations. For example, it might be discussed with metastatic or very aggressive cancers, such as inflammatory breast cancer, because these may need immediate treatment. But it is not the default recommendation.
Breast cancer surgery during pregnancy
It is generally safe to have breast cancer surgery during pregnancy. This includes surgery to remove the cancer in your breast and nearby lymph nodes. It is a major part of treatment for anyone with early breast cancer.
Your options for breast cancer surgery might include:
- Mastectomy to remove the entire breast
- Breast-conserving surgery (lumpectomy) to remove just the part of the where there is cancer
The type of surgery you need will depend on the extent of your cancer. It will also depend on how far you are in your pregnancy.
The lymph nodes under your arm also need to be checked for cancer.
During pregnancy, this is usually done with an axillary lymph node dissection (ALND). Several lymph nodes are removed during this procedure.
A sentinel lymph node biopsy (SLNB) may be an option in certain situations, such as later in pregnancy. An SLNB removes fewer lymph nodes, but the blue dye sometimes used during SLNB is not recommended during pregnancy because of potential risks to the baby. If you get an SLNB, a radioactive tracer without blue dye will probably be used.
Surgery for breast cancer generally carries little risk to the baby. But at certain times during pregnancy, anesthesia may be risky for the baby. Anesthesia is medicine used to make you sleep during surgery.
The team helping with this will include:
- Your surgeon
- An anesthesiologist who specializes in giving medicines during surgery
- A high-risk obstetrician (OB)
These doctors will need to work together to decide the best time to operate during your pregnancy.
If the surgery is done later in your pregnancy, your OB may be there just in case there are any problems with the baby during surgery. Together, your doctors will decide which anesthesia medicines and techniques are the safest for both you and the baby.
Chemo and other treatments after surgery
You might need more treatment after surgery. This will depend on the stage of your cancer and other factors.
Treatment after surgery is called adjuvant treatment. The goal is to help lower the risk of the cancer coming back. It could include chemotherapy, radiation therapy, hormone therapy, and/or targeted therapy. In some cases, this treatment can be put off until after the baby is delivered.
Chemotherapy (chemo) may be used after surgery for some earlier stages of breast cancer, as adjuvant treatment. It also can be used by itself for more advanced cancers.
Chemo is not given during the first 3 months (first trimester) of pregnancy.
The safety of chemo has not been studied in the first trimester, because a lot of the baby’s development happens during this time. The risk of miscarriage (losing the baby) is also the greatest during this time.
If you have early breast cancer and need chemo after surgery, it will usually be delayed until at least your second trimester.
For many years, it was thought that all chemo would harm an unborn baby no matter when it was given. But studies have shown that certain chemo medicines seem to be safe for the baby during the second and third trimesters (months 4 through 9).
These chemo medicines include doxorubicin, cyclophosphamide, fluorouracil, and the taxanes.
- When they are used during the second and third trimesters, these medicines do not raise the risk of birth defects, stillbirths, or health problems shortly after birth.
- However, they may increase the risk of early delivery.
- Researchers still do not know if these children will have any long-term effects.
If you are already in the third trimester when the cancer is found, your chemo may be delayed until after you give birth.
Chemo is generally not recommended after 35 weeks of pregnancy or within 3 weeks of delivery because it can lower your blood cell counts. This could cause bleeding and increase the chances of infection during birth.
Holding off on chemo during the last few weeks before delivery allows your blood counts to return to normal before you give birth.
The birth may be brought on (induced) a few weeks early for some people. This might also be done if the cancer is more advanced.
Treatments that usually wait until after delivery
Some treatments for breast cancer can harm the baby and are not safe during pregnancy. If you need any of these treatments, they are usually scheduled after the baby is born.
Radiation therapy to the breast is often used after breast-conserving surgery (lumpectomy) to help reduce the risk of the cancer coming back.
The high doses of radiation can harm a baby any time during pregnancy. This may cause miscarriage, birth defects, slow fetal growth, or a higher risk of childhood cancer. Because of this, doctors do not use radiation treatment during pregnancy.
For some people whose cancer is found later in the pregnancy, it may be possible to have a lumpectomy and then wait until after the baby is born to get radiation therapy. But this has not been well-studied. Waiting too long to start radiation can increase the chance of cancer coming back.
To avoid radiation during pregnancy, your cancer care team might recommend mastectomy. Most people do not need radiation therapy after a mastectomy.
If your breast cancer is hormone receptor-positive (estrogen and/or progesterone), you might get hormone therapy. This is often used as adjuvant treatment after surgery, or as treatment for advanced breast cancer. Hormone therapy medicines used for breast cancer include tamoxifen, anastrozole, letrozole, and exemestane.
Hormone therapy should not be given during pregnancy because it can affect the baby. It should be delayed until after the birth.
HER2-targeted drugs
Targeted drugs used to treat HER2-positive breast cancer are not considered safe during pregnancy. Studies show they can harm a developing baby, particularly the baby’s developing kidneys.
These drugs include trastuzumab (Herceptin), pertuzumab (Perjeta), ado-trastuzumab emtansine (Kadcyla), trastuzumab deruxtecan (Enhertu), tucatinib (Tukysa), and lapatinib (Tykerb).
Other targeted drugs
Everolimus (Afinitor), CDK4/6 inhibitors, and other targeted drugs are also not considered safe to use during pregnancy.
Can I breastfeed during cancer treatment?
According to most doctors, breastfeeding is not recommended during cancer treatment.
Chemo and other systemic medicines: Many chemo, hormone, and targeted therapy medicines can enter breast milk and be passed on to the baby. Breastfeeding is not recommended if you are being treated with these systemic medicines. Sometimes, it should be avoided for months after treatment ends.
Some people with hormone receptor-positive breast cancer are given medicines to stop the production of breast milk.
Breast surgery: Stopping breastfeeding before surgery reduces blood flow to your breasts and makes them smaller. This can help with breast surgery. It also helps reduce the risk of infection in the breast and can help avoid breast milk collecting in biopsy or surgery areas.
Talk with your healthcare team if you have questions about breastfeeding.
- If you are interested in breastfeeding after treatment, ask when it might be safe to start.
- Also ask if surgery or any other treatments will affect your ability to make breast milk.
- If you plan to start breastfeeding after you’ve stopped for a while, plan ahead.
Breastfeeding (lactation) experts can give you extra help if you need it.
Does pregnancy affect survival rates for breast cancer?
Pregnancy can make breast cancer harder to detect and diagnose. This may lead to later-stage diagnosis. However, most studies have found that survival outcomes for pregnant and non-pregnant people are similar when cancers are compared at the same stage.
- There is no evidence that ending a pregnancy improves a person’s overall survival or cancer outcome.
- Studies have also not shown that the treatment delays sometimes required during pregnancy worsen breast cancer outcomes.
- There are no reports showing that breast cancer itself can harm the baby.
Having a baby after you finish treatment
Having another baby after cancer treatment is generally considered safe. The right time to start trying often depends on your specific cancer type and treatment. It could be a few months or a few years. Your care team can help you figure out the right timeline.
Some breast cancer treatments can affect your ability to have children. Talk to your care team if you are thinking about growing your family after treatment. They can help you understand your options.
Learn more about this in Pregnancy After Breast Cancer.
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: July 9, 2026
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