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National Cancer Institute

at the National Institutes of Health

Breast Cancer Treatment and Pregnancy (PDQ)

Patient Version
Last Modified: 09/19/2013

Table of Contents

General Information about Breast Cancer and Pregnancy

Stages of Breast Cancer

Inflammatory Breast Cancer

Recurrent Breast Cancer

Treatment Option Overview

Treatment Options by Stage

Early Stage Breast Cancer (Stage I and Stage II)
Late Stage Breast Cancer (Stage III and Stage IV)

Other Considerations for Pregnancy and Breast Cancer

To Learn More About Breast Cancer and Pregnancy

Changes to This Summary (09/19/2013)

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General Information about Breast Cancer and Pregnancy

Key Points for This Section

 Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the
breast.
Breast cancer is sometimes detected (found) in women who are pregnant or have just
given birth.
Possible signs of breast cancer include a lump or change in the breast.
It may be difficult to detect (find) breast cancer early in pregnant or nursing women,
whose breasts are often tender and swollen.
Breast examination should be part of prenatal and postnatal care.
Tests that examine the breasts are used to detect (find) and diagnose breast cancer.
If cancer is found, tests are done to study the cancer cells.
Certain factors affect prognosis (chance of recovery) and treatment options.

Breast cancer is a disease in which malignant (cancer) cells form in the

tissues of the breast.

The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which
have many smaller sections called lobules. The lobes and lobules are connected by thin tubes
called ducts.
Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes,
lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

Each breast also contains blood vessels and lymph vessels. The lymph vessels carry an almost
colorless fluid called lymph. The lymph vessels lead to small, bean-shaped organs called lymph
nodes that help the body fight infection and disease. Lymph nodes are found throughout the
body. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above
the collarbone, and in the chest.

Breast cancer is sometimes detected (found) in women who are pregnant

or have just given birth.

In women who are pregnant or who have just given birth, breast cancer occurs most often
between the ages of 32 and 38. Breast cancer occurs about once in every 3,000 pregnancies.

Possible signs of breast cancer include a lump or change in the breast.

Breast cancer may cause any of the following signs and symptoms. Check with your doctor if you
have any of the following problems:

A lump or thickening in or near the breast or in the underarm area.

 A change in the size or shape of the breast.
A dimple or puckering in the skin of the breast.
A nipple turned inward into the breast.
Fluid, other than breast milk, from the nipple, especially if it's bloody.
Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin that is
around the nipple).
Dimples in the breast that look like the skin of an orange, called peau dorange.

Other conditions that are not breast cancer may cause these same symptoms.

It may be difficult to detect (find) breast cancer early in pregnant or

nursing women, whose breasts are often tender and swollen.

Women who are pregnant, nursing, or have just given birth usually have tender, swollen breasts.
This can make small lumps difficult to detect and may lead to delays in diagnosing breast cancer.
Because of these delays, cancers are often found at a later stage in these women.

Breast examination should be part of prenatal and postnatal care.

To detect breast cancer, pregnant and nursing women should examine their breasts themselves.
Women should also receive clinical breast examinationsduring their routine prenatal and
postnatal examinations.

Tests that examine the breasts are used to detect (find) and diagnose
breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures
may be used:

Physical exam and history : An exam of the body to check general signs of health,
including checking for signs of disease, such as lumps or anything else that seems
unusual. A history of the patients health habits and past illnesses and treatments will
also be taken.
Clinical breast exam (CBE): An exam of the breast by a doctor or other health
professional. The doctor will carefully feel the breasts and under the arms for lumps or
anything else that seems unusual.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves,
and a computer to make a series of detailed pictures of areas inside the body. This
procedure is also called nuclear magnetic resonance imaging (NMRI).
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are
bounced off internal tissues or organs and make echoes. The echoes form a picture of
body tissues called a sonogram.
Mammogram : An x-ray of the breast. A mammogram can be performed with little risk
to the fetus. Mammograms in pregnant women may appear negative even though cancer
is present.
 Mammography. The breast is pressed between two plates. X-rays are used to take
pictures of breast tissue.
Blood chemistry studies : A procedure in which a blood sample is checked to measure
the amounts of certain substances released into the blood by organs and tissues in the
body. An unusual (higher or lower than normal) amount of a substance can be a sign of
disease in the organ or tissue that makes it.
Biopsy : The removal of cells or tissues so they can be viewed under a microscope by
a pathologist to check for signs of cancer. If a lump in the breast is found, the doctor may
need to remove a small piece of the lump. Four types of biopsies are as follows:
Excisional biopsy : The removal of an entire lump of tissue.
Incisional biopsy : The removal of part of a lump or a sample of tissue.
Core biopsy : The removal of tissue using a wide needle.
Fine-needle aspiration (FNA) biopsy : The removal of tissue or fluid, using a
thin needle.

If cancer is found, tests are done to study the cancer cells.

Decisions about the best treatment are based on the results of these tests. The tests give
information about:

How quickly the cancer may grow.

How likely it is that the cancer will spread through the body.
 How well certain treatments might work.
How likely the cancer is to recur (come back).

Tests include the following:

Estrogen and progesterone receptor test : A test to measure the amount

of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more
estrogen and progesterone receptors than normal, the cancer may grow more quickly.
The test results show whether treatment to block estrogen and progesterone may stop the
cancer from growing.
Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory
test to measure how many HER2/neu genes there are and how much
HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or
higher levels of HER2/neu protein than normal, the cancer may grow more quickly and is
more likely to spread to other parts of the body. The cancer may be treated
with drugs that target the HER2/neu protein, such as trastuzumab (Herceptin)
and lapatinib (Tykerb).
Multigene tests: Tests in which samples of tissue are studied to look at the activity of
many genes at the same time. These tests may help predict whether cancer will spread to
other parts of the body or recur (come back).
Oncotype DX: This test helps predict whether stage I or stage II breast
cancer that is estrogen receptor positive and node-negative will spread to other
parts of the body. If the risk of the cancer spreading is high, chemotherapy may
be given to lower the risk.
MammaPrint: This test helps predict whether stage I or stage II breast cancer
that is node-negative will spread to other parts of the body. If the risk of the
cancer spreading is high, chemotherapy may be given to lower the risk.

Certain factors affect prognosis (chance of recovery) and treatment

options.

The prognosis (chance of recovery) and treatment options depend on the following:

The stage of the cancer (whether it is in the breast only or has spread to other places in
the body).
The size of the tumor.
The type of breast cancer.
The age of the fetus.
Whether there are symptoms.
The patients general health.

Stages of Breast Cancer

Key Points for This Section

 After breast cancer has been diagnosed, tests are done to find out if cancer cells have
spread within the breast or to other parts of the body.
Methods used to stage breast cancer can be changed to make them safer for the fetus.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
The following stages are used for breast cancer:
Stage 0 (carcinoma in situ)
Stage I
Stage II
Stage IIIA
Stage IIIB
Stage IIIC
Stage IV

After breast cancer has been diagnosed, tests are done to find out if
cancer cells have spread within the breast or to other parts of the body.

The process used to find out if the cancer has spread within the breast or to other parts of the
body is called staging. The information gathered from the staging process determines the stage of
the disease. It is important to know the stage in order to plan treatment.

Methods used to stage breast cancer can be changed to make them safer
for the fetus.

Standard methods for giving imaging scans can be adjusted so that the fetus is exposed to
less radiation. The following tests and procedures may be used in the staging process:

Sentinel lymph node biopsy : The removal of the sentinel lymph node during surgery.
The sentinel lymph node is the first lymph node to receive lymphatic drainage from
a tumor. It is the first lymph node the cancer is likely to spread to from the tumor.
A radioactive substance and/or blue dye is injected near the tumor. The substance or dye
flows through the lymph ducts to the lymph nodes. The first lymph node to receive the
substance or dye is removed. A pathologist views the tissue under a microscope to look
for cancer cells. If cancer cells are not found, it may not be necessary to remove more
lymph nodes.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas
inside the body, taken from different angles. The pictures are made by a computer linked
to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or
 tissues show up more clearly. This procedure is also called computed tomography,
computerized tomography, or computerized axial tomography.
Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells,
in the bone. A very small amount of radioactive material is injected into a vein and travels
through the bloodstream. The radioactive material collects in the bones and is detected
by a scanner.
PET scan (positron emission tomography scan): A procedure to
find malignant tumor cells in the body. A small amount of radioactiveglucose (sugar) is
injected into a vein. The PET scanner rotates around the body and makes a picture of
where glucose is being used in the body. Malignant tumor cells show up brighter in the
picture because they are more active and take up more glucose than normal cells do.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves,
and a computer to make a series of detailed pictures of areas inside the body. This
procedure is also called nuclear magnetic resonance imaging (NMRI).
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are
bounced off internal tissues or organs and make echoes. The echoes form a picture of
body tissues called a sonogram. The picture can be printed to be looked at later.
Chest x-ray : An x-ray of the organs and bones inside the chest. An x-ray is a type of
energy beam that can go through the body and onto film, making a picture of areas inside
the body.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system.
The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer
travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away
from where they began (the primary tumor) and travel through the lymph system or blood.

Lymph system. The cancer gets into the lymph system, travels through the lymph vessels,
and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a
tumor (metastatic tumor) in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if breast
cancer spreads to the bone, the cancer cells in the bone are actually breast cancer cells. The
disease is metastatic breast cancer, not bone cancer.
The following stages are used for breast cancer:

This section describes the stages of breast cancer. The breast cancer stage is based on the results
of testing that is done on the tumor and lymph nodes removed during surgery and other tests.

Stage 0 (carcinoma in situ)

There are 3 types of breast carcinoma in situ:

Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are
found in the lining of a breast duct. The abnormal cells have not spread outside the duct
to other tissues in the breast. In some cases, DCIS may become invasive cancer and
spread to other tissues. At this time, there is no way to know which lesions could become
invasive.

Ductal carcinoma in situ (DCIS). Abnormal cells are found in the lining of a breast
duct.
Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in
the lobules of the breast. This condition seldom becomes invasive cancer. However,
having LCIS in one breast increases the risk of developing breast cancer in either breast.
 Lobular carcinoma in situ (LCIS). Abnormal cells are found in the lobules of the
breast.
Paget disease of the nipple is a condition in which abnormal cells are found in
the nipple only.

Stage I
Stage I breast cancer. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast. In
stage IB, no tumor is found in the breast or the tumor is 2 centimeters or smaller. Small clusters of cancer cells
(larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.

In stage I, cancer has formed. Stage I is divided into stages IA and IB.

In stage IA, the tumor is 2 centimeters or smaller. Cancer has not spread outside
the breast.
In stage IB, small clusters of breast cancer cells (larger than 0.2 millimeter but not larger
than 2 millimeters) are found in the lymph nodes and either:
no tumor is found in the breast; or
the tumor is 2 centimeters or smaller.

Stage II

Stage II is divided into stages IIA and IIB.

In stage IIA:
no tumor is found in the breast or the tumor is 2 centimeters or
smaller. Cancer (larger than 2 millimeters) is found in 1 to 3 axillary lymph
nodes or in the lymph nodes near the breastbone (found during a sentinel lymph
node biopsy); or
the tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer
has not spread to the lymph nodes.
 Stage IIA breast cancer. No tumor is found in the breast and cancer is found in 1 to 3 axillary lymph
nodes or lymph nodes near the breastbone (left panel); OR the tumor is 2 centimeters or smaller and
cancer is found in 1 to 3 axillary lymph nodes or lymph nodes near the breastbone (middle panel); OR
the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the lymph
nodes (right panel).
In stage IIB, the tumor is:
larger than 2 centimeters but not larger than 5 centimeters. Small clusters
of breast cancer cells (larger than 0.2 millimeter but not larger than 2
millimeters) are found in the lymph nodes; or
larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to
1 to 3 axillary lymph nodes or to the lymph nodes near thebreastbone (found
during a sentinel lymph node biopsy); or
larger than 5 centimeters. Cancer has not spread to the lymph nodes.
 Stage IIB breast cancer. The tumor is larger than 2 centimeters but not larger than 5 centimeters and
small clusters of cancer cells are found in the lymph nodes (left panel); OR the tumor is larger than 2
centimeters but not larger than 5 centimeters and cancer is found in 1 to 3 axillary lymph nodes or
lymph nodes near the breastbone (middle panel); OR the tumor is larger than 5 centimeters and has not
spread to the lymph nodes (right panel).

Stage IIIA
Stage IIIA breast cancer. No tumor is found in the breast or the tumor may be any size and cancer is found in 4 to
9 axillary lymph nodes or lymph nodes near the breastbone (left panel); OR the tumor is larger than 5
centimeters and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are
found in the lymph nodes (middle panel); OR the tumor is larger than 5 centimeters and cancer is found in 1 to 3
axillary lymph nodes or lymph nodes near the breastbone (right panel).

In stage IIIA:

no tumor is found in the breast or the tumor may be any size. Cancer is found in 4 to
9 axillary lymph nodes or in the lymph nodes near thebreastbone (found during imaging
tests or a physical exam); or
the tumor is larger than 5 centimeters. Small clusters of breast cancer cells (larger than
0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or
the tumor is larger than 5 centimeters. Cancer has spread to 1 to 3 axillary lymph nodes
or to the lymph nodes near the breastbone (found during asentinel lymph node biopsy).

Stage IIIB
Stage IIIB breast cancer. The tumor may be any size and cancer has spread to the chest wall and/or to the skin of
the breast and caused swelling or an ulcer. Cancer may have spread to axillary lymph nodes or lymph nodes near
the breastbone. Cancer that has spread to the skin of the breast may be inflammatory breast cancer.

In stage IIIB, the tumor may be any size and cancer has spread to the chest wall and/or to the
skin of the breast and caused swelling or an ulcer. Also, cancer may have spread to:

up to 9 axillary lymph nodes; or

the lymph nodes near the breastbone.

Cancer that has spread to the skin of the breast may also be inflammatory breast cancer. See the
section on Inflammatory Breast Cancer for more information.

Stage IIIC
Stage IIIC breast cancer. No tumor is found in the breast or the tumor may be any size and may have spread to
the chest wall and/or the skin of the breast. Also, cancer has spread to 10 or more axillary lymph nodes (left
panel); OR to lymph nodes above or below the collarbone (middle panel); OR to axillary lymph nodes and lymph
nodes near the breastbone (right panel).

In stage IIIC, no tumor is found in the breast or the tumor may be any size. Cancer may have
spread to the skin of the breast and caused swelling or anulcer and/or has spread to the chest
wall. Also, cancer has spread to:

10 or more axillary lymph nodes; or

lymph nodes above or below the collarbone; or
axillary lymph nodes and lymph nodes near the breastbone.

Cancer that has spread to the skin of the breast may also be inflammatory breast cancer. See the
section on Inflammatory Breast Cancer for more information.

For treatment, stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

Stage IV
Stage IV breast cancer. The cancer has spread to other parts of the body, most often the bones, lungs, liver, or
brain.

In stage IV, cancer has spread to other organs of the body, most often the bones, lungs, liver, or
brain.

Inflammatory Breast Cancer

 In inflammatory breast cancer, cancer has spread to the skin of the breast and the breast looks
red and swollen and feels warm. The redness and warmth occur because the cancer cells block
the lymph vessels in the skin. The skin of the breast may also show the dimpled appearance
called peau dorange (like the skin of an orange). There may not be any lumps in the breast that
can be felt. Inflammatory breast cancer may be stage IIIB, stage IIIC, or stage IV.

Inflammatory breast cancer of the left breast showing peau dorange and inverted nipple.

Recurrent Breast Cancer

Recurrent breast cancer is cancer that has recurred (come back) after it has been treated. The
cancer may come back in the breast, in the chest wall, or in other parts of the body.

Treatment Option Overview

Key Points for This Section

There are different types of treatment for patients with breast cancer.
Treatment options for pregnant women depend on the stage of the disease and the age of
the fetus.
Three types of standard treatment are used:
Surgery
Radiation therapy
 Chemotherapy
New types of treatment are being tested in clinical trials.
Hormone therapy
Ending the pregnancy does not seem to improve the mothers chance of survival.

There are different types of treatment for patients with breast cancer.

Different types of treatment are available for patients with breast cancer. Some treatments
are standard (the currently used treatment), and some are being tested in clinical trials. A
treatment clinical trial is a research study meant to help improve current treatments or obtain
information on new treatments for patients with cancer. When clinical trials show that a new
treatment is better than the standard treatment, the new treatment may become the standard
treatment.

For some patients, taking part in a clinical trial may be the best treatment choice. Many of today's
standard treatments for cancer are based on earlier clinical trials. Patients who take part in a
clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the
future. Even when clinical trials do not lead to effective new treatments, they often answer
important questions and help move research forward.

Some clinical trials only include patients who have not yet received treatment. Other trials test
treatments for patients whose cancer has not gotten better. There are also clinical trials that test
new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer
treatment.

Clinical trials are taking place in many parts of the country. Information about clinical trials is
available from the NCI Web site.

Treatment options for pregnant women depend on the stage of the

disease and the age of the fetus.

Three types of standard treatment are used:

Surgery

Most pregnant women with breast cancer have surgery to remove the breast. Some of the lymph
nodes under the arm are usually taken out and looked at under a microscope to see if they
contain cancer cells.
Types of surgery to remove the breast include:

Simple mastectomy: A surgical procedure to remove the whole breast that contains
cancer. Some of the lymph nodes under the arm may also be removed for biopsy. This
procedure is also called a total mastectomy.

Total (simple) mastectomy. The dotted line shows where the entire breast is
removed. Some lymph nodes under the arm may also be removed.
Modified radical mastectomy: A surgical procedure to remove the whole breast that has
cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and
sometimes, part of the chest wall muscles.
 Modified radical mastectomy. The dotted line shows where the entire breast and
some lymph nodes are removed. Part of the chest wall muscle may also be removed.

Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes
the following:

Lumpectomy: A surgical procedure to remove a tumor (lump) and a small amount of

normal tissue around it. Most doctors also take out some of the lymph nodes under the
arm.
Partial mastectomy: A surgical procedure to remove the part of the breast that contains
cancer and some normal tissue around it. Some of the lymph nodes under the arm may
also be removed for biopsy. This procedure is also called a segmental mastectomy.
Breast-conserving surgery. Dotted lines show the area containing the tumor that is removed and some of the
lymph nodes that may be removed.

Even if the doctor removes all of the cancer that can be seen at the time of surgery, the patient
may be given radiation therapy, chemotherapy, orhormone therapy after surgery to try to kill any
cancer cells that may be left. Treatment given after surgery, to lower the risk that the cancer will
come back, is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types
of radiation to kill cancer cells. There are two types of radiation therapy. External
radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal
radiation therapy uses a radioactivesubstance sealed in needles, seeds, wires, or catheters that
are placed directly into or near the cancer. The way the radiation therapy is given depends on the
type and stage of the cancer being treated.

Radiation therapy should not be given to pregnant women with early stage (stage I or II) breast
cancer because it can harm the fetus. For women with late stage (stage III or IV) breast cancer, it
should not be given during the first 3 months of pregnancy.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by
killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth
or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells
throughout the body (systemic chemotherapy). When chemotherapy is placed directly into
the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect
cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends
on the type and stage of the cancer being treated.

Chemotherapy should not be given during the first 3 months of pregnancy. Chemotherapy given
after this time does not usually harm the fetus but may cause early labor and low birth weight.

See Drugs Approved for Breast Cancer for more information.

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not
mention every new treatment being studied. Information about clinical trials is available from
the NCI Web site.

Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops
cancer cells from growing. Hormones are substances made by glands in the body and circulated
in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the
cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation
therapy is used to reduce the production of hormones or block them from working.

The effectiveness of hormone therapy, alone or combined with chemotherapy, in treating breast
cancer in pregnant women is not yet known.

Ending the pregnancy does not seem to improve the mothers chance of
survival.

Because ending the pregnancy is not likely to improve the mothers chance of survival, it is not
usually a treatment option.

Treatment Options by Stage

Early Stage Breast Cancer (Stage I and Stage II)

Treatment of early stage breast cancer (stage I and stage II) may be surgery followed by adjuvant
therapy as follows:
 Modified radical mastectomy.
Breast-conserving surgery: Lumpectomy, partial mastectomy or segmental mastectomy.
Breast-conserving surgery during pregnancy followed by radiation therapy after the baby
is born.
Surgery during pregnancy followed by chemotherapy after the first 3 months of
pregnancy.
Clinical trials of surgery followed by hormone therapy with or without chemotherapy.
Late Stage Breast Cancer (Stage III and Stage IV)

Treatment of late stage breast cancer (stage III and stage IV) may include the following:

Radiation therapy.
Chemotherapy.

Radiation therapy and chemotherapy should not be given during the first 3 months of pregnancy.

Other Considerations for Pregnancy and Breast Cancer

Key Points for This Section

Lactation (breast milk production) and breast-feeding should be stopped if surgery or
chemotherapy is planned.
Breast cancer does not appear to harm the fetus.
Pregnancy does not seem to affect the survival of women who have had breast cancer in
the past.
Effects of certain cancer treatments on later pregnancies are not known.

Lactation (breast milk production) and breast-feeding should be stopped

if surgery or chemotherapy is planned.

If surgery is planned, breast-feeding should be stopped to reduce blood flow in the breasts and
make them smaller. Breast-feeding should also be stopped if chemotherapy is planned. Many
anticancer drugs, especially cyclophosphamide and methotrexate, may occur in high levels in
breast milk and may harm the nursing baby. Women receiving chemotherapy should not breast-
feed. Stopping lactation does not improve survival of the mother.

Breast cancer does not appear to harm the fetus.

Breast cancer cells do not seem to pass from the mother to the fetus.
Pregnancy does not seem to affect the survival of women who have had
breast cancer in the past.

Some doctors recommend that a woman wait 2 years after treatment for breast cancer before
trying to have a baby, so that any early return of the cancerwould be detected. This may affect a
womans decision to become pregnant. The fetus does not seem to be affected if the mother has
previously had breast cancer.

Effects of certain cancer treatments on later pregnancies are not known.

The effects of treatment with high-dose chemotherapy and a bone marrow transplant, with or
without radiation therapy, on later pregnancies are not known.

To Learn More About Breast Cancer and Pregnancy

For more information from the National Cancer Institute about breast cancer and pregnancy, see
the following:

Breast Cancer Home Page

What You Need to Know About Breast Cancer
Breast Cancer Prevention
Breast Cancer Screening
Surgery Choices for Women with DCIS or Breast Cancer
Drugs Approved for Breast Cancer
Reproductive History and Breast Cancer Risk

For general cancer information and other resources from the National Cancer Institute, see the
following:

What You Need to Know About Cancer

Understanding Cancer Series: Cancer
Cancer Staging
Chemotherapy and You: Support for People With Cancer
Radiation Therapy and You: Support for People With Cancer
Coping with Cancer: Supportive and Palliative Care
Questions to Ask Your Doctor About Cancer
Cancer Library
Information For Survivors/Caregivers/Advocates

Changes to This Summary (09/19/2013)

The PDQ cancer information summaries are reviewed regularly and updated as new information
becomes available. This section describes the latest changes made to this summary as of the date
above.
Editorial changes were made to this summary.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer
information database. The PDQ database contains summaries of the latest published information
on cancer prevention, detection, genetics, treatment, supportive care, and complementary and
alternative medicine. Most summaries come in two versions. The health professional versions
have detailed information written in technical language. The patient versions are written in easy-
to-understand, nontechnical language. Both versions have cancer information that is accurate
and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the
federal governments center of biomedical research. The PDQ summaries are based on an
independent review of the medical literature. They are not policy statements of the NCI or the
NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about the treatment of breast
cancer and pregnancy. It is meant to inform and help patients, families, and caregivers. It does
not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These
Boards are made up of experts in cancer treatment and other specialties related to cancer. The
summaries are reviewed regularly and changes are made when there is new information. The
date on each summary ("Date Last Modified") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which
is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better
than another. Trials are based on past studies and what has been learned in the laboratory. Each
trial answers certain scientific questions in order to find new and better ways to help cancer
patients. During treatment clinical trials, information is collected about the effects of a new
treatment and how well it works. If a clinical trial shows that a new treatment is better than one
currently being used, the new treatment may become "standard." Patients may want to think
about taking part in a clinical trial. Some clinical trials are open only to patients who have not
started treatment.

Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors
who take part in clinical trials are also listed in PDQ. For more information, call the Cancer
Information Service 1-800-4-CANCER (1-800-422-6237).

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NCIs PDQ cancer information summary about breast cancer prevention states the risks in the
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The best way to cite this PDQ summary is:

National Cancer Institute: PDQ Breast Cancer Treatment and Pregnancy. Bethesda, MD:
National Cancer Institute. Date last modified <MM/DD/YYYY>. Available
at: http://cancer.gov/cancertopics/pdq/treatment/breast-cancer-and-pregnancy/Patient.
Accessed <MM/DD/YYYY>.

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