New Delhi, 25 August 2025: In a remarkable display of medical coordination and expertise, Sir Ganga Ram Hospital has successfully managed a rare and complex case of breast cancer in a pregnant woman—safeguarding the lives of both mother and child. The case underscores the critical importance of a multidisciplinary approach in handling oncological emergencies during pregnancy.
Case Overview: A Dual Challenge
The patient, a 35-year-old woman who was five months pregnant, presented to the hospital in July 2024 with a breast lump. Due to the risks of radiation to the fetus, mammography was ruled out. Instead, a whole-body MRI was performed, which revealed a tumor in the left breast along with axillary lymph node involvement but no signs of metastasis.
A biopsy confirmed invasive breast cancer, classified as triple-positive—meaning it was positive for Estrogen, Progesterone, and HER2neu receptors.
Facing the Dilemma: Treatment vs. Pregnancy
The patient was presented with three treatment options:
- Terminate the pregnancy and begin aggressive cancer treatment.
- Undergo surgery first, followed by chemotherapy.
- Begin with chemotherapy, then proceed with surgery.
After comprehensive counselling by the oncology team, the patient opted for surgery-first treatment. A mastectomy was performed by Dr. Rakesh Kr. Koul, Co-Chairperson of Surgical Oncology, with successful removal of the tumor.
Post-surgery analysis showed lymph node involvement, necessitating further treatment.
Safe Chemotherapy During Pregnancy
“Chemotherapy is safe after the first trimester, with minimal risk to the fetus,” said Dr. Shyam Aggarwal, Chairperson of Medical Oncology. However, he emphasized that Anti-HER2neu therapy is strictly contraindicated during pregnancy.
The patient underwent 12 weekly cycles of Paclitaxel chemotherapy, which she tolerated well. Throughout the treatment, fetal development was closely monitored and remained normal.
In January 2025, she delivered a healthy baby through a normal vaginal delivery.
Post-Delivery Comprehensive Cancer Treatment
After delivery, the patient was able to begin the next phase of her cancer treatment, which included:
- Adjuvant chemotherapy: 4 cycles of anthracycline-based agents
- Radiotherapy: Targeted to the surgical site
- Anti-HER2neu therapy: Trastuzumab and Pertuzumab for one year
- Hormonal therapy: Planned for eight years
Both mother and newborn are currently in excellent health with no reported complications.
A Model Case for Collaborative Cancer Care
“This case highlights how a multidisciplinary team can make all the difference in complex cancer cases,” said Dr. Aggarwal. “We combined surgical, medical, and obstetric expertise to achieve the best possible outcome—saving both lives.”
Dr. Rakesh Koul echoed the sentiment, stating, “Timely diagnosis, patient-centered counselling, and teamwork allowed us to offer effective breast cancer treatment without compromising the safety of the unborn child.”
Key Takeaways from the Case
- Surgery and chemotherapy are both safe for pregnant patients after the first trimester.
- Anti-HER2neu therapy must be deferred until after delivery.
- A multidisciplinary approach involving surgical oncologists, medical oncologists, radiologists, obstetricians, and supportive care providers is crucial.
- With proper planning, both maternal and fetal outcomes can be optimized.
Sir Ganga Ram Hospital continues to demonstrate leadership in complex oncology cases by delivering personalized and evidence-based care. This case stands as a testament to the power of coordinated, compassionate medicine, and provides hope to many women facing similar challenges during pregnancy.
