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Chemotherapy
Source: Breast Cancer Treatment During Pregnancy (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: December 4, 2024 · Captured 2026-09-09.
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Context: Treatment of Early/Localized/Operable Breast Cancer During Pregnancy
Data suggest that it is safe to administer certain chemotherapeutic drugs after the first trimester, with most pregnancies resulting in live births with low rates of morbidity in the newborns.
Anthracycline-based chemotherapy (doxorubicin plus cyclophosphamide or fluorouracil, doxorubicin, and cyclophosphamide [FAC]) appears to be safe to administer during the second and/or third trimester on the basis of limited prospective data.[6-8] Safety data on the use of taxanes during pregnancy are limited.
Evidence (use of chemotherapy during the second and/or third trimester of pregnancy):
A multicenter case-control study compared pediatric outcomes of 129 children whose mothers had breast cancer with matched children of women without cancer. In the pregnancy study group, 96 children (74.4%) were exposed to chemotherapy, 11 (8.5%) to radiation therapy, 13 (10.1%) to surgery alone, 2 (1.7%) to other drug treatments, and 14 (10.9%) to no treatment.[9]
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A multicenter case-control study compared pediatric outcomes of 129 children whose mothers had breast cancer with matched children of women without cancer. In the pregnancy study group, 96 children (74.4%) were exposed to chemotherapy, 11 (8.5%) to radiation therapy, 13 (10.1%) to surgery alone, 2 (1.7%) to other drug treatments, and 14 (10.9%) to no treatment.[9]
The study showed that there was no significant difference in birth weight below the 10th percentile (22% in the breast cancer treatment‒exposed group vs. 15.2% in the control group, P = .16) or in cognitive development based on the Bayley score (P = .08). The gestational age at birth was correlated with cognitive outcome in the two study groups.
A multicenter case-control study compared pediatric outcomes of 129 children whose mothers had breast cancer with matched children of women without cancer. In the pregnancy study group, 96 children (74.4%) were exposed to chemotherapy, 11 (8.5%) to radiation therapy, 13 (10.1%) to surgery alone, 2 (1.7%) to other drug treatments, and 14 (10.9%) to no treatment.[9]
Evaluation of cardiac function among 47 children, who were age 36 months in the study group, showed normal cardiac findings.
In a prospective single-arm study, 57 pregnant patients with breast cancer were treated with FAC in the adjuvant or neoadjuvant setting.[6]
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In a prospective single-arm study, 57 pregnant patients with breast cancer were treated with FAC in the adjuvant or neoadjuvant setting.[6]
Survey data collected when the children were aged 2 months to 157 months revealed that no stillbirths, miscarriages, or perinatal deaths occurred.
In a prospective single-arm study, 57 pregnant patients with breast cancer were treated with FAC in the adjuvant or neoadjuvant setting.[6]
One child born vaginally at a gestational age of 38 weeks had a subarachnoid hemorrhage on day 2 postpartum, one child had Down syndrome, and two children had congenital anomalies (club foot and bilateral ureteral reflux).
The findings of the prospective single-arm study above were consistent with other smaller retrospective series of anthracycline-based chemotherapy.[7,8]
A systematic review studied 40 case reports of taxane administration during the second or third trimesters of pregnancy.[10]
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A systematic review studied 40 case reports of taxane administration during the second or third trimesters of pregnancy.[10]
Minimal maternal, fetal, or neonatal toxicity was observed.
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Preserved source evidence · Not medical advice