A diagnosis of breast cancer or DCIS while you are pregnant can be a significant shock. It is normal to be concerned about how the diagnosis and treatment will impact your pregnancy, your baby and your overall health and wellbeing.

Some treatments are not recommended if you are pregnant but there are still options available to you. Your surgical, oncology and obstetric team will be able to help you navigate this difficult time. They can help you understand that it means for your treatment and care.

Treatment options when pregnant

Your doctors will recommend the best treatment for you based on:

•  what type of breast cancer you have
• the size of the tumour and where it is in your breast
• whether the cancer has spread and, if so, where to
• how far your pregnancy has progressed.

Surgery for breast cancer during pregnancy

Treatment for breast cancer in pregnant women can include breast surgery and/or chemotherapy.

Breast surgery after the first trimester is considered safe and the risk of miscarriage is low.

Radiotherapy for breast cancer while pregnant

If doctors recommend radiotherapy, this will not start until after the baby is born. Radiation is a significant risk for an unborn child.

Some pregnant women choose to have a mastectomy rather than a lumpectomy (‘breast conserving surgery’). This means they can avoid radiotherapy.

Systemic therapies

'Systemic' treatments are those that treat the whole body, not just a local area. 

Chemotherapy 

During the first trimester, doctors do not recommend chemotherapy as it may harm the unborn baby.

During the second and third trimesters, when the risk of harm is lower, chemotherapy is sometimes given. Certain chemotherapy drugs have been proven safe in pregnant women.

Other systemic treatments

During pregnancy, doctors do not recommend these systemic treatments:

• hormone-blocking therapy
• targeted therapies such as trastuzumab
• immunotherapy.

Help to decide on treatment

You don’t have to make any decisions about your treatment alone. Your obstetric and oncology team should include health professionals with experience in caring for women diagnosed with cancer while pregnant. Together, they can help you make the best choices for you and your baby.

Your doctor or breast care nurse can also refer you to a psychologist or social worker.

Avoiding pregnancy during treatment

It is recommended that you do not become pregnant while you are having treatment for breast cancer or DCIS.

Your contraception choices can be limited, especially if your cancer is hormone receptor positive. Non-hormonal contraception, such as a diaphragm or condoms, is recommended while you are having treatment.

If you are unsure what contraception to use, ask your doctor.

Pregnancy after treatment finishes

Studies show it's safe to have a baby after treatment for early breast cancer. It is important, though, that you discuss this with your treating team. There are guidelines on the best ('optimal') timing for pregnancy after treatment.

Once you complete treatment for DCIS, there is no evidence that pregnancy affects your risk of DCIS returning or your risk of developing an invasive breast cancer.

Resources

BCNA’s Online Network is a community where you can find support from people who share your experiences.

BCNA's Helpline team is here to provide support and information for people at all stages of the breast cancer experience.

Cancer Australia has more information about pregnancy during breast cancer.

The US charity Hope For Two provides support to women diagnosed with breast cancer while pregnant.

Podcast: Sally Obermeder on her breast cancer journey

Well known TV personality and business owner Sally Obermeder was 40 weeks pregnant with her first child when she was diagnosed with triple negative Stage 3 breast cancer. One week after her daughter was born, she returned to hospital to begin chemotherapy.

Sally speaks about her experience from diagnosis to treatment, including her decision to use a surrogate for her second child.