Key points
- Chemotherapy in the first trimester (organogenesis) raises the risk of malformations and should be avoided [1].
- From the second trimester, many regimens (anthracyclines, taxanes, platinum) can be given with relatively low risk [1].
- Trastuzumab, hormone therapy and methotrexate should not be used in pregnancy [1].
- Termination of pregnancy often gives no benefit for the outcome of the mother's treatment [1].
Principles
| Topic | Recommendation |
|---|---|
| Imaging | Ultrasound and MRI without gadolinium; chest X-ray with shielding; CT and PET only when essential |
| Surgery | Possible in any trimester; sentinel node biopsy with a radioisotope (not blue dye) |
| Chemotherapy | From week 14 onwards; dose based on actual body weight |
| Radiotherapy | Usually deferred until after delivery; radiotherapy away from the uterus in selected cases |
| Delivery | Preferably at 37 weeks or later; last chemotherapy about 3 weeks before delivery to avoid neutropenia in mother and baby |
| Breastfeeding | Contraindicated during chemotherapy |
Fertility preservation and pregnancy after treatment: fertility preservation lesson [2].
Related cancer types
Treatment regimens (physicians)
AC followed by paclitaxel (dose-dense and weekly)TC regimen (docetaxel and cyclophosphamide): dose and scheduleTCHP regimen: dose and schedule in HER2-positive breast cancerWeekly paclitaxel with trastuzumab (APT regimen)KEYNOTE-522 regimen: pembrolizumab and chemotherapy in triple-negative breast cancerTrastuzumab emtansine (T-DM1, Kadcyla): dose and scheduleTrastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringAdjuvant capecitabine after neoadjuvant treatment (CREATE-X)Sacituzumab govitecan (Trodelvy)Pembrolizumab with chemotherapy in metastatic triple-negative breast cancer (KEYNOTE-355)Carboplatin and paclitaxel in ovarian cancerWeekly cisplatin with radiotherapy (cervical cancer)
Physician tools and lessons
Cumulative Anthracycline Dose and Doxorubicin EquivalentsTumour Lysis Syndrome: Cairo-Bishop Criteria and PreventionKhorana Score (Cancer-Associated Thrombosis Risk)HCT-CI Comorbidity Index Before Stem Cell TransplantationIPI, R-IPI, NCCN-IPI and CNS-IPI Calculator for DLBCLFollicular Lymphoma International Prognostic Index (FLIPI) CalculatorInternational Prognostic Score (IPS) for Advanced Hodgkin LymphomaMantle Cell Lymphoma International Prognostic Index (MIPI) CalculatorIndications for haematopoietic stem cell transplantation, donor selection and conditioningGraft-versus-host disease (GVHD): prophylaxis, grading and treatment
References
2 referencesShow all references, 1 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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