Breast Cancer and Pregnancy

While a diagnosis of breast cancer during pregnancy can be overwhelming, treatment is possible – and often successful – with with careful planning to protect both mother and baby.

At the Janet Knowles Breast Cancer Center at MD Anderson Cancer Center at Cooper, our medical, surgical, and radiation oncologists work closely with maternal-fetal medicine specialists to provide advanced, compassionate care for this uncommon condition. Cooper experts also consult with local oncologists and obstetricians and participate in cutting-edge research to improve treatment and outcomes for women diagnosed with breast cancer during pregnancy.

Pregnancy itself is often protective against breast cancer because it lowers exposure to the female hormones estrogen and progesterone. Other factors, such as a woman’s age at first childbirth and number of pregnancies, also influence risk.

Research shows that pregnant women who receive appropriate and timely care for breast cancer have survival rates similar to women who are not pregnant.

Diagnosing Breast Cancer During Pregnancy

Pregnancy and breastfeeding naturally change the breasts, sometimes making it harder to detect abnormalities through physical exams or imaging. Women may notice symptoms such as:

• A lump in the breast.
• An inverted nipple.
• Red or itchy skin on or around the breast.

Diagnosis usually begins with imaging studies and a biopsy. A mammogram may be performed during pregnancy with a protective shield over the abdomen. Biopsies, which remove a small tissue sample for analysis, are safe during pregnancy.

At Cooper’s Breast Imaging Centers, we use advanced technologies including mammography, ultrasound, and MRI to provide accurate diagnoses. After breast cancer is confirmed, additional tests – such as physical exams, imaging, and biopsy results – help determine the stage of the cancer.

Not all tests are needed for every patient. Your care team will recommend the most appropriate tests for you.

Treatment Options 

Your treatment plan will be customized based on the type and stage of cancer, your medical history, and how far along you are in your pregnancy. Our specialists work together to protect your health and your baby’s well-being.

First trimester

• Mastectomy (removal of the entire breast) is often recommended if surgery is needed early in pregnancy. Reconstruction may be possible at the time of surgery or after delivery.
• Lumpectomy (removal of the tumor only) is usually delayed because it typically requires radiation, which cannot be given during pregnancy.
• Chemotherapy is not given during the first trimester because this is when the baby’s organs are developing.

Second trimester

• Both mastectomy and lumpectomy may be options. Radiation is delayed until after delivery.
• Chemotherapy may be safely given during this stage because the baby is more developed.
• Regular ultrasounds are recommended to monitor fetal growth.

Third trimester

• Surgical options are the same as in the second trimester.
• Chemotherapy may be given until about the 35th week of pregnancy to allow time for recovery before delivery.
• Weekly fetal monitoring with maternal-fetal medicine specialists is recommended.

Breastfeeding Considerations

Breastfeeding is possible for some women during treatment, but it depends on your care plan:

• Safe during surgery or biopsy: Breastfeeding is generally safe after these procedures.
• Not safe during chemotherapy: Medicines can pass to the baby through breast milk.
• Radiation and infections: Treatment may lower milk supply or increase infection risk.

Feeding from the healthy breast alone often provides enough nutrition. Talk with your doctor if breastfeeding is a priority for you.

Common Misconceptions About Breastfeeding

Some myths about breastfeeding and breast cancer include:
Myth: Babies refuse milk from a cancerous breast.
Fact: Refusal usually happens only if the taste changes or milk supply drops.

Myth: Anesthesia passes into breast milk.
Fact: Anesthesia medicines leave the body quickly; breastfeeding is safe once you recover.

Myth: Needle aspiration affects milk production.
Fact: It does not affect milk supply.

Myth: Imaging tests affect milk production.
Fact: Imaging does not impact milk supply, but emptying the breast beforehand can help with testing.

Cancer and Pregnancy Registry

Because breast cancer during pregnancy is rare, most doctors treat only a few such patients in their careers. To improve understanding and care, Dr. Elyce Hope Cardonick, a maternal-fetal medicine specialist at Cooper, established the Cancer and Pregnancy Registry.

This registry collects confidential information on diagnosis and treatment to help researchers worldwide learn more about cancer during pregnancy. Mothers and children are followed even after delivery to better understand long-term outcomes.

Finding Support

A breast cancer diagnosis during pregnancy can feel overwhelming. Emotional support from family, friends, and healthcare providers can make a difference.
Cooper’s Cancer Care Support Services connect patients with counselors, social workers, support groups, and community resources. Additional organizations offering support include:

• Hope for Two: Pregnant with Cancer Network. This support network can match you to a support woman who was treated for breast cancer during pregnancy and has already delivered her child.
• Facts for Life: Breast Cancer During Pregnancy, from the Susan G. Komen Foundation.
• Young Survival Coalition.
• Social support resources, from the Susan G. Komen Foundation.