A diagnosis of breast cancer can be particularly confronting for women who are still planning to have children or who are currently pregnant. Many women immediately wonder whether treatment will affect their fertility, whether pregnancy will still be possible in the future, or whether trying to conceive after treatment could increase the risk of cancer returning. 

The reassuring news is that many women can still have children after breast cancer treatment, and research continues to improve fertility options and pregnancy outcomes for women diagnosed during their reproductive years. Breast cancer can also occur during pregnancy, although this is uncommon, and specialised medical teams work carefully to protect both mother and baby, emphasising the importance of tailored pregnancy and breast cancer treatment. 

Understanding the relationship between fertility, pregnancy and breast cancer can help women make informed decisions about treatment and future family planning. This guide explains how breast cancer treatments may affect fertility, options such as egg freezing and IVF, pregnancy after treatment, and the specialist care available in Australia.  

How Breast Cancer Treatment Can Affect Fertility 

Some breast cancer treatments can affect the ovaries and the body’s ability to conceive. However, the impact varies widely depending on factors such as age, the type of treatment used, and how the ovaries respond. 

Chemotherapy and fertility

Chemotherapy works by targeting rapidly dividing cells. While this is effective against cancer cells, it can also affect healthy cells, including those in the ovaries that produce eggs. Different chemotherapies impact the ovaries to varying degrees. As a result, some women may experience: 

• Temporary infertility 
• Reduced fertility 
• Permanent infertility in some cases 

Younger women generally have a higher chance of ovarian recovery after treatment compared with older women. 

Some women also experience early menopause, particularly if chemotherapy significantly affects ovarian function. 

Breast cancer treatment can also delay pregnancy plans. For some women, treatment may continue for several years, particularly if hormone therapy is recommended after chemotherapy or surgery. This delay can reduce fertility opportunities over time, especially as natural fertility declines with age. Discussing future family plans with your healthcare team before treatment begins can help you understand your options and consider fertility preservation if appropriate. 

Tamoxifen and fertility

Tamoxifen is a hormone therapy commonly used to reduce the risk of breast cancer returning. It is typically taken for five to ten years, which can delay pregnancy plans as pregnancy is not recommended whilst taking tamoxifen. 

Because fertility decisions are time-sensitive, it is important to discuss fertility preservation before breast cancer treatment begins. 

Research improving fertility options 

Australian researchers have played an important role in improving fertility outcomes for women with breast cancer. The POEMS clinical trial, led by Breast Cancer Trials, showed that a medication called Zoladex (Goserelin) can be used to temporarily suppress ovarian function during chemotherapy and help protect fertility in some women. 

This research has helped expand options for women who hope to have children after treatment. 

Women are also encouraged to explore resources from organisations such as Cancer Australia and Breast Cancer Network Australia (BCNA) when considering fertility planning. 

Early Menopause and Breast Cancer 

Some women experience early menopause as a result of breast cancer treatment. 

Early menopause occurs when the ovaries stop functioning before the age of 45. Chemotherapy can damage ovarian tissue, reducing the body’s ability to produce hormones and eggs. 

Symptoms of early menopause may include: 

• Hot flushes 
• Sleep disturbances 
• Vaginal dryness 
• Mood changes 
• Reduced libido 

For younger women, the emotional impact of early menopause can be significant, particularly if they had hoped to have children in the future. Symptoms of menopause can also have a significant effect, impacting a woman’s ability to work, exercise and care for their family. 

Managing symptoms and understanding fertility implications are important parts of care. Women experiencing these effects may benefit from guidance from both oncology specialists and menopause or fertility experts. 

You can learn more in our guides on early-onset breast cancer, early menopause, and young women and breast cancer. 

Fertility and Breast Cancer Options

Several options are available to help preserve fertility before breast cancer treatment begins. These approaches are usually arranged quickly after diagnosis, before chemotherapy or other treatments start. 

Breast cancer and egg freezing

Egg freezing involves stimulating and then collecting mature eggs from the ovaries and storing them for future use. This allows women the possibility of pregnancy later, even if treatment affects ovarian function. 

Breast cancer and embryo freezing

Embryo freezing is similar to egg freezing but involves collecting and then fertilising the eggs with sperm before freezing them. This process is known as in vitro fertilization (IVF). 

This option is the most reliable and may be suitable for women who have a partner or who wish to use donor sperm. 

Ovarian tissue freezing (ovarian tissue cryopreservation)

Ovarian tissue freezing is an emerging fertility preservation technique. A small amount of ovarian tissue is removed and stored for later transplantation. The transplanted ovarian tissue is then able to produce both eggs to restore fertility, as well hormones to prevent early menopause. 

This approach is newer but still considered an option to preserve fertility and may offer hope for some women. 

Ovarian suppression during chemotherapy 

Medications can sometimes be used during chemotherapy to temporarily suppress ovarian activity, which may reduce the risk of treatment-related infertility. 

The POEMS clinical trial conducted by Breast Cancer Trials, helped demonstrate the potential benefit of this approach. 

Timing and specialist referral 

Fertility preservation treatments usually need to be completed before chemotherapy begins, so early referral to a fertility specialist is important. 

In Australia, access to fertility services may be supported through Medicare and private fertility clinics, depending on the procedure. 

You can listen to our Q&A about breast cancer and fertility, moderated by Author and Journalist Annabel Crabb, here. 

Pregnancy After Breast Cancer – Is It Safe? 

Many women worry that pregnancy after breast cancer could increase the risk of recurrence.  

While individual circumstances vary, pregnancy after breast cancer does not increase the risk of cancer returning for most women. 

In many cases, survival outcomes for women who become pregnant after treatment are similar to those who do not. This is also true for patients with hormone receptor positive breast cancers and those with BRCA 1 or BRCA 2 mutations. 

Research shows that babies born to women who have previously had breast cancer generally do just as well as those born to women without a history of cancer. They experience normal growth and development, with no increased risk of birth defects, stillbirth, neonatal death or other major health problems. 

Doctors often recommend waiting around two years after treatment before trying to conceive, as this is when the breast cancer recurrence risk is typically highest. However, timing recommendations vary depending on the individual situation. 

Pausing endocrine therapy to try for pregnancy 

For some women with hormone receptor-positive breast cancer, endocrine therapy such as tamoxifen is recommended for five to ten years after treatment. This can delay plans to start or grow a family. 

The international POSITIVE clinical trial is investigating whether temporarily pausing endocrine therapy to attempt pregnancy is safe. Early results suggest that a planned interruption does not increase the short-term risk of breast cancer recurrence. However, longer-term follow-up is still underway, and any decision to pause treatment should be made in consultation with your treating team. 

Breast Cancer and Reproductive Concerns 

Even with reassuring research, many women experience anxiety about pregnancy after breast cancer. 

Common concerns include: 

• Fear of cancer recurrence 
• Concerns about hormone exposure during pregnancy 
• Emotional stress related to fertility decisions 

Oncofertility specialists and counselling services can help women navigate these complex decisions. 

Breast Cancer and IVF 

Some women require IVF (in vitro fertilisation) for infertility after breast cancer treatment. A common concern is whether IVF fertility injections could increase the risk of breast cancer developing or returning. 

IVF involves hormonal stimulation to encourage the ovaries to produce multiple eggs. Because these medications can temporarily increase oestrogen levels, some women worry about the potential link with breast cancer. 

Current research suggests that IVF does not significantly increase breast cancer risk in the general population. It appears to be safe in women with a history of breast cancer, even hormone receptor positive breast cancer. It also appears to be safe in those with inherited genetic mutations, such as BRCA1 or BRCA2. However individual risks may differ and personalised advice from specialists should always be sought when considering IVF after breast cancer. 

Consulting both a fertility specialist and an oncology team can help ensure treatment plans are safe and appropriate. Some women require multiple IVF cycles to retrieve enough eggs. Current evidence does not link repeated egg retrieval cycles with an increase in breast cancer recurrence risk. However, long-term data on this topic remains limited. 

Individualised medical advice is recommended when planning fertility treatment. 

Do repeated egg retrieval cycles increase breast cancer risk?

Current research does not show strong evidence that repeated egg retrieval cycles or fertility treatments increase the risk of developing breast cancer or of breast cancer recurring. While these treatments involve short-term rises in hormones like oestrogen, no clear long-term link with breast cancer has been established.  

If you are considering egg freezing or IVF, it’s important to speak with your oncologist and fertility specialist to understand your individual risk and options. 

Breast Cancer During Pregnancy

Although uncommon, breast cancer during pregnancy can occur. International estimates suggest it affects around 1 in 3,000 pregnancies. 

Pregnancy does not cause breast cancer. However, hormonal changes and normal breast changes during pregnancy can sometimes make diagnosis more difficult. 

For this reason, any breast lumps or unusual change should be assessed promptly, even during pregnancy. 

When breast cancer is diagnosed during pregnancy, treatment decisions are made by a multidisciplinary team, including oncologists, obstetricians and surgeons experienced in caring for pregnant patients. 

Can breast cancer during pregnancy affect the baby?

Breast cancer itself does not spread to the baby and many treatments can still be safely given during pregnancy with careful monitoring. 

For example: 

• Surgery is generally safe during pregnancy 
• Chemotherapy may be possible during the second and third trimesters 
• Radiotherapy and hormone therapy are usually delayed until after birth 

Close monitoring throughout pregnancy helps ensure both maternal and foetal health. 

Treatment Options for Breast Cancer During Pregnancy 

Breast cancer treatment during pregnancy requires careful planning to balance effective cancer treatment with the safety of the developing baby. 

• Surgery – Breast surgery is generally considered safe during all stages of pregnancy but is ideally performed after the first trimester. Procedures may include lumpectomy or mastectomy depending on the cancer type and stage.
• Chemotherapy – Chemotherapy is usually avoided during the first trimester, when the baby’s organs are forming. However, chemotherapy may be safely given during the second and third trimesters under specialist supervision. For more information on chemotherapy during pregnancy, view our dedicated article. 
• Radiotherapy during pregnancy – Radiotherapy is typically postponed until after delivery because radiation exposure may harm the developing baby.
• Endocrine therapy and pregnancy – Hormone therapies used to treat hormone-receptor-positive breast cancer are not recommended during pregnancy and are usually started after birth. Targeted therapy during pregnancy – Many targeted therapies are also avoided during pregnancy due to potential risks to the baby. Treatment decisions are always tailored to the individual situation. 

Birth Control After Breast Cancer Treatment

Women who have completed breast cancer treatment may still need reliable contraception, particularly while taking endocrine therapy. 

For women with hormone receptor-positive breast cancer, as well as those with HER2-positive or triple negative breast cancer, hormone-based contraceptives are generally avoided. These contraceptives contain oestrogen or progesterone, which may not be suitable after breast cancer treatment. Your healthcare team can recommend the most appropriate contraception option based on your individual circumstances. 

Non-hormonal options may be recommended, such as: 

• Copper intrauterine device (IUD) 
• Condoms or barrier methods 
• Fertility awareness methods in some cases 

Choosing the right contraception method should always involve discussion with a healthcare professional. 

Breast Cancer Research and Fertility in Australia

Research continues to improve fertility options for women diagnosed with breast cancer. 

Australian researchers and organisations such as Breast Cancer Trials are contributing to important studies on: 

• Fertility preservation techniques 
• Ovarian protection during chemotherapy 
• IVF safety after breast cancer 
• Hormone exposure and recurrence risk 

Clinical trials such as POEMS have already helped improve fertility outcomes for many women. 

Women interested in advancing research may consider discussing clinical trial participation with their healthcare team. 

Frequently Asked Questions

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A mastectomy is a major breast cancer surgery that involves removing one or both breasts to treat or reduce the risk of developing breast cancer. While it is a common and often effective treatment, the decision to have a mastectomy can feel overwhelming. Many people, including men and women, describe the lead-up to surgery as one of the most emotionally and practically challenging periods of their breast cancer journey.  

Emotionally, preparing for a mastectomy can bring up feelings of fear, uncertainty, grief, and anxiety. You may be processing the shock of a recent diagnosis, thinking about how your body will change, or wondering how you’ll cope physically and emotionally afterwards. It’s normal to experience concerns about body image, intimacy, sexuality, and identity – alongside worries about the surgery itself.  

Practically, there’s a lot to manage as well. From organising time off work and understanding your surgical options, to preparing your home environment, arranging support, and navigating pre-operative appointments, the planning phase can feel like a full-time job. Many people also find themselves juggling childcare, family responsibilities, financial considerations, and coordinating help for the first few weeks at home.  

Understanding what mastectomy recovery involves – physically, emotionally, and practically – can help you feel more prepared and supported. This article walks you through what to expect before and after surgery, tips for navigating recovery, and insights from people who’ve been there. If you’re still deciding about surgery, read our guide explaining types of mastectomy and reconstruction options. 

Mastectomy types and their impact on recovery 

Single mastectomy recovery

Single mastectomy recovery is generally more straightforward than a double mastectomy because only one side of the chest needs to heal. This means less discomfort, fewer limitations in arm movement, and a quicker return to daily tasks.    

Double mastectomy recovery

With a double mastectomy, because both sides of the chest are healing at once, women typically experience more pain, tightness, and fatigue during the early weeks. Arm mobility can be significantly reduced, making everyday activities, like getting out of bed, reaching overhead, or dressing, more challenging at first but many women regain strength and mobility steadily with guided exercises and appropriate follow-up care.   

Mastectomy recovery timeline: what to expect 

Recovery happens in phases, and no two people heal in the same way. The below timeframes are general guidelines only. 

0–2 weeks: Immediate post-op 

• Hospital stay of 1–2 days 

• Some level of pain is expected, as well as swelling, bruising, tightness and limited arm movement 

• Surgical drains may be in place 

• No heavy lifting until advised by your doctor 

• Rest, gentle walking, and wound care are prioritised 

• Wear a breast binder or post-surgical bra 

• Watch for signs of infection, including redness, increased swelling, warmth, pus or fever 

2–6 weeks: Short-term healing 

• Gradual return to everyday activities 

• Increased arm mobility 

• Fatigue and emotional shifts are common 

• Follow your surgeon’s guidance on driving and lifting 

6 weeks+: Long-term recovery and lifestyle adjustments 

• Most women resume daily life and work (as appropriate) 

• Scar healing, ongoing physiotherapy, and emotional adjustment 

• Those with reconstruction may take longer to fully recover 

• Fatigue can persist for several months 

“What I wish I knew before mastectomy”: real stories & reflections

Many women say the emotional side of recovery can be just as challenging as the physical. Some reflections include:  

“Recovery is not linear. It can feel like a roller coaster, with ups and downs along the way, and it will look different for everyone both physically and emotionally. Try not to compare your recovery to anyone else’s, be kind to yourself, and allow yourself to take the time you need to heal”- Katrina  

“Look into post operative physiotherapy options early, rather than waiting for issues to arise. Taking an active role in your recovery asking about safe exercise, mobility, and long-term function can make a meaningful difference. If something doesn’t feel right post op speak up.” – Katrina  

“I wish I knew before my mastectomy not to get caught up with buying multiple bras, in built bra tank tops and swimmers and then an array of pillows to assist post surgery. It all adds up financially and I know everyone is different, but for me it wasn’t necessary. It was panic buying in my case.” – Kate  

Emotional and mental preparation

It’s normal to feel anxious, uncertain, or overwhelmed while preparing for a mastectomy. Many women find this time emotionally challenging as they process how surgery may change their body and what it might mean for their sexuality and identity. 

Concerns about appearance, recovery, and what life will look like afterwards can all contribute to fear about life post mastectomy. These feelings are common and understandable. You should discuss any concerns that you have about your planned surgery with your treatment team. 

What to do before surgery

The most important thing before a mastectomy is to make sure that you understand the planned surgery, reconstruction options and likely recovery. Consider keeping a notebook with a list of questions to make sure you don’t forget to ask anything. 

There are also practical preparations that can help make the experience of surgery and recovery easier. Taking time to organise your home and arrange support can mean you head into surgery feeling more informed and in control and make the first weeks of recovery much easier.

Factors that affect mastectomy recovery

Every woman’s recovery is unique, and several medical and personal factors influence how quickly and comfortably you heal. These can affect your physical recovery timeline, your emotional wellbeing, and the type of support you may need after surgery. 

Why breast cancer stage affects mastectomy recovery

Recovery can vary based on breast cancer stage because: 

• In early breast cancer when there is an emphasis on prompt treatment, emotional recovery may be more complex, especially if the cancer is aggressive or treatment decisions were made quickly. 

• Locally advanced cancers may require more extensive surgery to the breast and axilla, such as an axillary clearance, which increases pain, swelling, and the risk of lymphoedema. 

• Reconstruction timing may be influenced by stage: women needing radiation post-surgery may have delayed reconstruction, affecting both short and long-term recovery timelines. 

• People with advanced cancer may also be undergoing chemotherapy or radiation therapy or have other cancer related symptoms which can slow wound healing and prolong fatigue. 

• Other factors that influence recovery: 

• • Age and general health: Younger, fitter women often recover faster. Pre-existing conditions (diabetes, heart conditions, obesity) and cigarette smoking/vaping may slow healing. 

• • Type of mastectomy: Single, double, skin-sparing, nipple-sparing 

• • Axillary surgery: whether a sentinel lymph node biopsy or axillary clearance are performed. 

• • Reconstruction choices: Immediate reconstruction, especially flap surgery, increases initial recovery time.
    Complications: Infections, seromas, lymphoedema and cording (or axillary web syndrome) can prolong recovery. 

• • Seroma: pockets of fluid can develop in the immediate weeks after surgery. This can feel like a soft or hard swelling under the skin. Seromas often disappear by themselves over time but can sometimes need draining. 

• • Lymphoedema: a build-up of lymph fluid in the tissues because the lymphatic system is damaged, blocked, or not working as well as it should. This extra fluid causes swelling, heaviness, tightness, and discomfort often in the chest wall or arm. Unlike a seroma, it cannot be drained. 

• • Cording (axillary web syndrome): rope-like cords that appear under the skin of your inner arm. This can feel painful or tight and make it hard to lift your arm or straighten your elbow fully. 

• • Emotional health: Anxiety, trauma, or body image concerns may affect overall wellbeing and pace of recovery. 

Skin-sparing and nipple-sparing recovery

Physical recovery after a skin-sparing or nipple-sparing mastectomy is generally similar to a traditional mastectomy, though the preserved skin or nipple may need extra care as it heals. Emotionally, some women find the process easier because more of their natural breast contour is maintained, which can help with body image and adjustment. 

Practical tips for a smoother recovery

The fastest way to recover from a mastectomy is to follow the guidance of your treatment team, as they understand the specific needs of your surgery and overall health. While every woman’s recovery timeline is different, adopting healthy habits can support your healing, improve comfort, and help you regain strength more steadily. Many patients find that small, consistent actions make a meaningful difference in how they feel day to day. 

These additional habits contribute to a quicker recovery: 

• Take medications as prescribed 

• Practice deep breathing and coughing 

• Sleep slightly upright on your back for the first few weeks to reduce pain and pressure on wounds and drains as well as reduce swelling  

• Keep wound and drain sites clean 

• Start gentle physiotherapy exercises as instructed 

• Options include the BCNA ‘Strengthen Your Recovery’ Pilates program (‘Strengthen Your Recovery’ Pilates Program)  and the Westmead Breast Cancer Institute Shoulder Care exercises (Shoulder Care Fact Sheet | Westmead BCI) 

• Learn more about the benefits of exercise for breast cancer patients  

• Maintain hydration and balanced nutrition 

• Reach out to your treatment team with any questions or if you need support 

Things you need after a mastectomy

Having the right items on hand can make your recovery more comfortable and help you move around with greater ease in the first few weeks after surgery. These practical tools and sources of support can reduce strain on your body, help manage pain or swelling, and provide emotional comfort during a challenging time. 

Your treatment team will provide you a list of items required to support your journey that is personalised to your situation.

Some additional items that may help physically or emotionally include: 

• Comfort cushions or post-surgical cushions (you may be provided with a cushion whilst in hospital) 

• Front-button shirts 

• Soft wire-free bra. Front opening bras can be easier to use with limited arm mobility (you may be provided with a bra whilst in hospital) 

• Drain care kit including a drain bag and cleaning supplies 
• A journal for emotional processing 
• Support from friends, family, or professionals.  

Home care after mastectomy

Caring for yourself at home is an important part of healing after a mastectomy. Establishing a simple routine for wound care, rest, and gradual movement can help prevent complications and support a smoother recovery. Your treatment team will give you specific instructions, but these are the common elements of home care: 

• Regular wound checks 

• Drain management 

• Dressing changes 

• Avoiding strenuous activity 

• Good hygiene and rest 

When can you resume normal activities? 

Disclaimer: This information is general in nature and not a substitute for medical advice. Always consult your GP or treating specialists for guidance tailored to your own breast cancer diagnosis and recovery. 

Timelines vary widely from person to person, but these general guidelines can help manage expectations: 

• Lifting your arms: It is ideal to limit overhead arm movement for up to 2 weeks post operatively, or longer if drains remain in place. Patients should also avoid lifting anything over 2kg for up to 6 weeks depending on your surgery. Always check with your surgeon for specific advice for your situation. 

• Driving: Typically allowed after 2–3 weeks, once you can safely shoulder-check, turn the wheel, and are no longer taking strong pain medication. This is usually after your post-operative follow up appointment with your surgeon. It is important to feel confident before returning to driving – if you feel anxious about driving speak to your treatment team. 

• Returning to work: Many women return to light duties between 4–6 weeks, but this is very dependent on the type of surgery and the type of work performed. Physically demanding jobs may require significantly more time off. 

• Fatigue: Fatigue is very common after a mastectomy and can persist for several months which can affect when women feel ‘back to normal’ 

Personal variability and the importance of medical clearance 

Recovery looks different for everyone. Factors like age, overall health, the type of mastectomy, lymph node removal, and whether reconstruction was performed all affect how quickly you can return to normal activities. Some women feel ready within a few weeks, while others need several months due to pain, fatigue, or limited mobility.  

Because of these differences, medical clearance is advised before resuming activities such as lifting, driving, or strenuous movement. Your treatment team will assess wound healing, drain removal, shoulder mobility, and any signs of complications to determine what’s safe for you.  

Even if you feel ready, pushing too hard too soon can lead to setbacks. Follow-up appointments and physiotherapy help ensure you return to daily routines at a pace that protects your healing and long-term wellbeing. 

Emotional recovery

Emotional recovery is a real part of healing after a mastectomy, and it’s completely normal for it to feel just as challenging – sometimes more so – than the physical recovery. It can also take much longer than the physical healing and vary widely between individuals. 

Patients who have a mastectomy may experience sadness at the loss of a breast. They may also experience sexuality and identity shifts, as well as fears about recurrence.  

When possible, immediate breast reconstruction is thought to lead to improved psychological, emotional and social outcomes, as the patient wakes from their surgery with a new breast. But even with reconstruction it usually takes 3–12 months for women to feel better about their body image. 

Whilst it can be confronting, it is important to look at your chest after your surgery. This allows you to monitor your healing and detect any complications like seromas or infections. It also helps you adjust to your new body image. If you are anxious about seeing your new chest after your surgery, you should discuss this with your treatment team. 

It is important to discuss any difficulties with emotional recovery with your treatment team, and to consider engaging with counselling or psychology and peer support groups. 

Emotional and mental support options

Support is available in many forms, including counselling or psychology services to help you process emotions, peer support groups where you can connect with others who’ve had similar experiences, and breast care nurses who can provide guidance, reassurance, and practical advice throughout your treatment and recovery. Self-care strategies like eating well, resting adequately, exercising and practicing mindfulness and deep breathing exercises for if you feel anxious are also important to implement. 

You can read more about mental health and breast cancer, sexual health after breast cancer and other useful resources on our website.   

When to contact your doctor

It is important to monitor your symptoms closely after surgery, as early signs of complications can sometimes be subtle. Paying attention to changes in your body and contacting your treatment team promptly can help prevent small issues from becoming more serious. Most patients have follow up with their surgeon several weeks after their surgery, however you should seek additional medical advice if you notice: 

• Redness, heat, swelling or pus around the wound 

• Fever or chills 

• Feeling generally unwell 

• Sudden fluid build-up (possible seroma) 

• Severe pain not controlled by medication 

• Restricted shoulder or elbow movement 

• Issues with drains 

• Attend all follow-up appointments to stay on track with your recovery

Returning to work after mastectomy

Returning to work after a mastectomy is an important milestone for many women, but the timing can vary widely depending on the type of surgery, your overall health, your job demands, and how you’re feeling physically and emotionally. Most women return to work somewhere between 4–8 weeks after surgery, although some may require longer – especially after a double mastectomy or reconstruction. 

Physical readiness:

Before going back to work, asses your physical readiness and whether you can comfortably manage the physical demands of your role. Some questions you can ask yourself are: 

• Can you sit, stand, or move comfortably for extended periods? Prolonged sitting or repetitive arm movements can feel tiring or uncomfortable in early recovery. 

• Is your arm and shoulder mobility adequate? Many jobs require reaching, lifting, or turning – activities that may still be restricted. 

• Are you still experiencing significant pain or fatigue? Fatigue can linger for weeks and even months, especially if you’re also undergoing reconstruction or other treatments. 

• Has your treatment team cleared you? Your surgeon or breast care nurse will assess wound healing, scar tissue, and your overall movement before advising whether it’s safe to return. 

Women with physically demanding jobs (e.g., nursing, childcare, hospitality, retail, or roles involving lifting) may need a longer recovery period or modified duties. 

Emotional Readiness:

Going back to work is not just a physical decision – it’s also an emotional one. It’s very important to assess your emotional readiness. Many women experience a range of feelings, including: 

• Anxiety about how colleagues will respond 

• Concerns about your new appearance, especially after going flat and even after reconstruction 

• Reduced confidence or difficulty concentrating 

• Feeling overwhelmed or fatigued by social or sensory environments 

It’s helpful to ask yourself: 

• Do I feel emotionally supported and ready for social interaction? 

• Can I manage stress without feeling overwhelmed? 

• Do I need more time to rest or adjust before returning to routine? 

Emotional readiness can be just as important as physical readiness, and it’s okay to request more time if you need it. 

Tips for a phased return to work

A gradual return can help you rebuild strength, confidence, and stamina without overwhelming yourself. Here are some options to consider: 

Reduced hours or part-time return (e.g., mornings only for the first 1–2 weeks) 

• Alternating work-from-home and in-office days, if possible 

• Light duties that avoid lifting, overhead movement, or strenuous activity 

• Scheduled rest breaks to manage fatigue 

• Adjusting your workstation for better posture and comfort (e.g., ergonomic chair, monitor height adjustments) 

Many women find that easing back into their routine helps prevent setbacks and supports long-term recovery. 

Communicating with your employer

Clear and proactive communication can make your return much smoother. Here are some considerations: 

• Letting your employer know about your expected timeline early, even if it may change 

• Requesting adjustments based on your treatment team’s recommendations 

• Discussing flexible arrangements, such as a phased return or modified duties 

• Providing medical certificates or recovery plans if required 

• Setting boundaries, such as not lifting heavy items or avoiding tasks that strain your upper body 

If you’re unsure how much detail to share, focus on the functional impact rather than the personal specifics. For example: 

“My doctor has advised that I avoid lifting and overhead reaching for the next few weeks. I may need modified duties until I regain full mobility.” 

Many workplaces are supportive when they understand what you need and why. 

Final tips: what patients say helped the most

Many women say that accepting help early, wearing loose clothing, and keeping a simple rest routine made recovery easier. Gentle movement can ease stiffness and connecting with others who’ve been through a mastectomy often provides valuable reassurance and practical advice.  

If you’d like to support research that improves breast cancer treatment options, please consider donating to Breast Cancer Trials. 

Frequently Asked Questions

Join Our Free Q&A Webinars

Don’t miss an opportunity to stay informed about the latest in breast cancer research and care. Join our FREE Q&A webinars, where we cover important topics including whether more young women are being diagnosed with breast cancer.

Stay Connected with Breast Cancer Trials

Don’t miss an opportunity to stay informed about the latest in breast cancer research and care. Sign up to our researcher’s newsletter via the form below to stay up to date.

What is a mastectomy?

A mastectomy is a surgical procedure to remove the entire breast, usually performed to treat breast cancer or substantially reduce the risk of developing it. Patients may choose or need to have a mastectomy for several reasons, including: 

• Treating early and locally advanced breast cancer that is still localised to the breast and surrounding lymph nodes 

• Reducing risk in people with high-risk genetic mutations that predispose to developing breast cancer (e.g., TP53, BRCA1 and BRCA2) 

• Treating breast cancer that has recurred in the breast after previous treatment 

• Rarely, people with advanced breast cancer that has spread beyond the breast and surrounding lymph nodes may also have a mastectomy to manage problems such as chronic cancer wounds 

Mastectomy vs. lumpectomy: what’s the difference?

The two main surgical options for managing breast cancer are mastectomy and lumpectomy, also known as a partial mastectomy or breast conserving surgery. 

• Mastectomy removes the whole breast. 

• Lumpectomy, or breast conserving surgery, removes only the tumour and a small margin of surrounding normal breast tissue. It usually requires post operative radiotherapy to treat the remaining breast tissue. 

• The right option depends on cancer stage, tumour size, genetic risk, and personal preference. 

When is a mastectomy recommended

A mastectomy can be recommended for a range of reasons including: 

• The tumour is large and there will be little normal breast tissue left after removal of the cancer, resulting in breasts that are significantly different sizes.  

• There are multiple tumours in different areas of the breast and removal of all the tumours would result in breasts that are significantly different shapes and sizes. 

• There is a large area of ductal carcinoma in situ (DCIS) that needs to be removed to reduce the risk of developing breast cancer 

• The person has a high-risk genetic mutation that predisposes to developing breast cancer (e.g., BRCA1/2) 

• They prefer mastectomy to reduce future breast cancer risk 

• They wish to avoid post mastectomy radiotherapy to the breast (noting this may still sometimes be required depending on tumour factors) 

Many women with early-stage breast cancer (stage 0-II) can choose between lumpectomy and mastectomy and still have optimal treatment of their breast cancer. This is often paired with a sentinel lymph node biopsy which involves removal of only the first draining lymph nodes in the axilla (armpit), which is a lesser surgery with quicker recovery time than an axillary clearance.  

Women with locally advanced breast cancer (stage III) may be recommended to have a mastectomy, especially if the tumour is larger and not suitable for lumpectomy. These women often have cancer that has spread to multiple lymph nodes and requires removal of all the lymph nodes in the armpit, called an axillary clearance. An axillary clearance is a more extensive surgery than a sentinel lymph node biopsy that can increase the risk of complications like lymphoedema and prolong recovery time. 

Inflammatory breast cancer is a rare, aggressive type of breast cancer that doesn’t present as a lump but instead causes the breast to be red, swollen and tender due to cancer cells blocking lymph vessels in the skin. This is ideally treated with pre-operative chemotherapy, followed by a mastectomy to ensure that the entirety of the cancer is removed.  

A risk-reducing mastectomy is preventative (prophylactic) mastectomy due to high genetic risk or a strong family history of breast cancer.  This means it is performed because of the risk of breast cancer, not because a woman has breast cancer. Recovery may be physically easier because lymph nodes are typically not removed and there are no cancer-related symptoms to manage. 

Men and mastectomies

Men can also be diagnosed with breast cancer, which is commonly treated with a mastectomy as they have less breast tissue than women, meaning a lumpectomy may not be possible. Although breast cancer is less common in men, the physical and emotional impact of surgery can be just as significant. Men may face unique challenges, including delayed diagnosis, feelings of isolation, or a lack of awareness that breast cancer can affect them. Recovery after a mastectomy involves both physical healing and emotional adjustment, and men benefit from the same supports as women – clear information, medical guidance, and access to counselling or peer support. 

Who can I talk to about my treatment options? 

Your breast surgeon, breast care nurse, oncologist, or GP can guide you through benefits and risks, helping you make decisions aligned with your goals and values. 

 Types of mastectomy

The type of mastectomy you have can significantly influence your physical healing, emotional adjustment, and overall recovery after mastectomy. Each surgical option has its own benefits, considerations, and timelines for getting back to everyday life. Understanding these differences can help you prepare for the days, weeks, and months following your operation. 

Single vs. double mastectomy 

Single mastectomy

A single mastectomy involves removing one breast. This is usually all that is required for treatment of breast cancer, particularly if there is a low level of concern regarding development of cancer in the remaining breast. 

Double mastectomy

A double mastectomy removes both breasts and results in a longer and more demanding recovery. This usually occurs because of cancer in one breast and significant concerns about developing cancer in the other breast. Women can have breast cancer in both breasts at the same time, but it is rare. 

Emotionally, some women find reassurance in removing both breasts, especially if they are at higher genetic risk, while others may need more time to adjust to the changes in their body. 

Breast reconstruction options: with or without breast reconstruction

Your recovery will also vary depending on whether you choose reconstruction, the type of reconstruction performed and the timing of reconstruction. 

No breast reconstruction (“going flat”)

No breast reconstruction, also known as flat closure and “going flat”, often results in: 

• A shorter operation 

• Fewer surgical sites (incisions) 

• A generally quicker recovery from mastectomy 

• Fewer risks related to implants or flap surgery 

•  Emotional recovery may take time as you adjust to a changed chest shape 

Decisions to consider: reconstruction vs going flat 

Choosing between reconstruction and going flat is a personal decision shaped by lifestyle, body image, and what feels right for you. Going flat offers a simpler surgery and recovery, which some women prefer, though adjusting to a flat chest can take time emotionally. 

Reconstruction can help restore breast shape and support body confidence for some, but it usually involves more extensive surgery and a longer healing process. Speaking with your surgeon, GP or breast care nurse can help you understand which option best aligns with your goals and comfort. 

Women who choose to ‘go flat’ also have non-surgical options including breast prostheses to recreate the shape of the breast without reconstruction. Prostheses are worn inside specialised bras and even swimwear and come in a range of sizes and weights that can be customised to the woman. There are government subsidies towards the cost of prostheses. 

Types of breast cancer reconstruction

There are 2 main types of reconstruction options, implant-based reconstruction and autologous flap reconstruction: 

• Implant-based reconstruction (using silicone or saline implants) 

• Autologous flap reconstruction (using tissue from another area of the body, such as the abdomen, back, or thighs) 

Implant based reconstruction can sometimes require a tissue expander which is a temporary device placed under the chest muscle or skin that is gradually filled with saline or air to allow the tissue to stretch prior to insertion of the permanent implant. 

Flap reconstruction has a longer recovery time as this surgery involves removing tissue from a separate part of the body (e.g abdomen in a DIEP flap) and attaching it to the chest wall to create the new breast shape.  This is more complicated surgery which can involve additional drains and more complex wound care, extend hospital stays, and restrict activity for several weeks. 

Single verses double reconstruction

Recovery time for bilateral reconstruction after double mastectomy is typically longer than going flat or having a single reconstruction after mastectomy on one side only. This is because surgery is required to both sides of the chest which means more time needed for healing and return to normal mobility and function. 

Immediate breast reconstruction 

Immediate reconstruction is performed during the same surgery as your mastectomy. Whilst this means that both the mastectomy and reconstruction are performed in the one surgery, it increases surgery time which may not be safe for patients with poorer general health. Immediate reconstruction also increases healing time which is not always ideal for more aggressive cancers that require treatment with post-operative chemotherapy. Some breast cancers also require post-operative radiation treatment which is preferrable to give prior to reconstruction.

Delayed reconstruction

Some women choose reconstruction months or years later. 

• A shorter initial mastectomy recovery period  

• More time to consider reconstruction options  

• Flexibility if further treatment (like radiation) is needed 

Skin-sparing and nipple-sparing mastectomies 

Skin-sparing and nipple-sparing mastectomies are specialised surgical techniques designed to preserve as much of the breast’s natural appearance as possible. 

• Skin-sparing mastectomy removes the breast tissue but keeps most of the overlying breast skin. 

• Nipple-sparing mastectomy goes a step further by also preserving the nipple and areola, if it is safe to do so based on the location and type of cancer. 

These approaches are often used when a woman chooses immediate reconstruction because the preserved skin and sometimes the nipple, provides a natural envelope for an implant or flap, resulting in a more natural-looking outcome. 

Patient perspectives: deciding on a mastectomy

“Don’t be afraid to ask questions even the ones that feel small or repetitive. Appointments can be overwhelming, and it’s easy to forget what you wanted to ask once you’re in the room. Writing a list beforehand and taking it with you can be incredibly helpful. If possible, bring someone along to your appointment. These conversations can be emotionally charged, and having another person there to listen, absorb the information, and help relay it back to you later when you have the mental space can make a difference. Your medical team is there to support you, and advocating for yourself isn’t being difficult; it’s being informed.”– Katrina 

“I wish I knew before my mastectomy not to get caught up with buying multiple bras, in built bra tank tops and swimmers and then an array of pillows to assist post surgery. It all adds up financially and I know everyone is different, but for me it wasn’t necessary. It was panic buying in my case”. – Kate 

“After two years, I had a breast reconstruction. This was the best decision. Not only did the reconstruction make me feel physically whole again, it also improved my self-confidence and emotional wellbeing. I had completely underestimated how much a reconstruction would help me heal mentally and emotionally. So, with the benefit of hindsight, I would have planned my reconstruction as early as practical.” – Merryn 

Read Merryn’s full story here. 

I wish I knew before my mastectomy that I didn’t have to rush the decision about reconstruction. And I did feel that it was a rushed decision. It’s difficult making that decision about reconstruction when you have no hair, feeling like a drugged up alien and when you’re exhausted and emotional. I found lots of resources supporting reconstruction but little about what it’s like to either wait after all treatment is completed before making a decision or about being flat permanently. I knew what the scarring would look like and a discussion about external prosthesis but little about the emotional aspect of being flat. And that’s what I needed to know, how other women dealt with the emotional side. – Kate  

These stories highlight the importance of preparing for physical, emotional, and lifestyle changes. 

Sources:

https://www.bcna.org.au/resources/articles/breast-cancer-in-men

https://nbcf.org.au/about-breast-cancer/further-information-on-breast-cancer/breast-cancer-in-men/

https://www.cancer.org.au/types-of-cancer/breast-cancer/breast-cancer-in-men

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Being diagnosed with breast cancer during pregnancy, or gestational breast cancer, can feel overwhelming, raising many urgent questions about treatment and the health of your baby. One of the most common concerns is whether chemotherapy during pregnancy is possible or safe. 

The reassuring news is that treatment decisions are carefully guided by medical evidence and Australian clinical guidelines. In many cases, chemotherapy can still be given during pregnancy, particularly in the later stages. When treating breast cancer in pregnancy, both cancer specialists and obstetric teams work closely to protect the health of both mother and baby. Understanding how chemotherapy is used during pregnancy can help you feel more informed and supported when making decisions about your care.  

Breast Cancer During Pregnancy

During pregnancy, the body produces higher levels of hormones such as oestrogen, which stimulate breast development to allow breast feeding. The mother’s immune system also changes to allow the growth of the baby. These and other factors can lead to the development of breast cancer during pregnancy. Normal breast changes during pregnancy – such as swelling, tenderness and increased breast density – can also make cancer harder to detect early. As a result, some women may be diagnosed at a slightly later stage. 

Even when diagnosed during pregnancy, many women can still receive effective cancer treatment. In some situations, chemotherapy may be recommended as part of treatment while pregnant, depending on the stage of breast cancer while pregnant, the type of breast cancer, and how far the pregnancy has progressed. 

Is Chemotherapy Safe During Pregnancy?

A key question many people ask is: is chemotherapy safe during pregnancy? 

The answer depends largely on the stage of pregnancy. 

Medical guidelines state that chemotherapy is not recommended during the first trimester, because this is when the baby’s organs are developing. Exposure to chemotherapy drugs during this early stage may increase the risk of miscarriage or birth defects. 

However, research and clinical experience show that most chemotherapy used in the treatment of breast cancer can often be safely given during the second trimester and third trimesters, when the baby’s major organs have already formed. At this stage, the risk of harm to the unborn baby is significantly lower. 

This approach allows doctors to continue treating the cancer without waiting until after delivery. 

Some other breast cancer treatments, such as trastuzumab, endocrine (hormonal) therapy such as tamoxifen and immunotherapy such as pembrolizumab, are not recommended for use at any stage during pregnancy due to risks to the baby. Doctors also carefully check which symptom control medications, like anti-nausea medications, can be safely given during pregnancy. 

For more information about treatment guidelines during breast cancer, visit Cancer Australia. 

What Trimester Can You Have Chemotherapy? 

The timing of chemotherapy during pregnancy is carefully planned. In general: 

Chemotherapy in first trimester (weeks 1–12): 

• Chemotherapy is not recommended. 

• This is when the baby’s organs are developing, so exposure to chemotherapy carries the greatest risk. 

Chemotherapy in second trimester (weeks 13–27): 

• Chemotherapy is commonly given during the second trimester. 

• The baby’s organs have already formed, reducing the risk of major birth defects. 

Chemotherapy in third trimester (weeks 28–birth): 

• Chemotherapy may still be given in the third trimester, depending on the situation. 

• Treatment is usually paused several weeks before delivery so that both mother’s and baby’s blood counts can recover and reduce the risk of complications during birth. 

Every pregnancy and cancer diagnosis is different, so the timing of treatment is tailored to each individual. 

How Does Chemotherapy Affect the Unborn Baby?

When chemotherapy is given during the first trimester, it can interfere with early organ development which may increase the risk of miscarriage or birth defects. This is why it is avoided during this stage of pregnancy. 

When chemotherapy is given after the first trimester, research suggests that most babies are born healthy. However, some risks can still occur, including: 

• Lower birth weight 

• A higher chance of early (preterm) delivery 

• Temporary effects like low blood cell counts related to timing of chemotherapy administration 

Encouragingly, studies following children exposed to chemotherapy in the womb during the second or third trimester generally show normal growth and development. 

To minimise risks, pregnancies are closely monitored by specialists throughout treatment. 

Is Breast Cancer During Pregnancy More Aggressive? 

Breast cancer diagnosed during pregnancy can be more aggressive than breast cancer diagnosed in non-pregnant women. It can also be more advanced at diagnosis because pregnancy-related breast changes can make tumours harder to detect. Whilst the same types of breast cancer affect both pregnant women  and non-pregnant women, there are slightly higher rates of triple negative and HER2 positive breast cancers.  

This is why any unusual breast changes during pregnancy – such as a lump, skin changes, or nipple discharge – should be assessed promptly. 

Early assessment helps ensure that effective treatment can begin as soon as possible. 

What Happens If You Need Chemotherapy While Pregnant?

If chemotherapy is recommended during pregnancy, care is usually managed by a multidisciplinary medical team. This may include: 

• Medical oncologists 

• Obstetricians experienced in high-risk pregnancies 

• Breast surgeons 

• Specialist nurses and midwives 

Together, they create an individualised treatment plan that carefully balances cancer treatment with pregnancy care. 

This typically includes: 

• Careful timing of chemotherapy cycles 

• Regular monitoring of the baby’s growth 

• Coordination of cancer treatment with the expected delivery date 

• Emotional and psychological support 

For many women, this coordinated approach allows them to continue their pregnancy while receiving essential cancer treatment. 

Other breast cancer treatments and pregnancy 

There are other treatments that are a part of breast cancer management, including surgery and radiotherapy. 

Surgery for breast cancer, including have an anaesthetic is considered low risk after the first trimester.  

Radiotherapy poses a significant risk to the baby and is delayed until after the baby is delivered. 

Frequently Asked Questions

Can you have chemotherapy while pregnant?

Yes, in many cases chemotherapy can be given during pregnancy, particularly during the second and third trimesters. It is generally avoided in the first trimester due to risks to the developing baby. 

What trimester is chemotherapy safe during pregnancy?

Chemotherapy is usually considered safest during the second and third trimesters, when the baby’s organs have already developed. 

How does chemotherapy affect the unborn baby?

When given after the first trimester, most babies are born healthy. Possible risks include lower birth weight or early delivery, but long-term development is generally normal. 

Is breast cancer during pregnancy more aggressive?

Breast cancer diagnosed during pregnancy can be more aggressive. It can also be detected later because normal pregnancy changes can make tumours harder to detect. However, it is still very treatable with the care of a multidisciplinary team. 

Can you breastfeed during chemotherapy?

No. Chemotherapy drugs can pass into breast milk and may harm the baby. Breastfeeding is not recommended while receiving chemotherapy. 

What are the treatment options when pregnant? 

Some treatments – such as endocrine (hormone) therapy, immunotherapy and certain targeted therapies – cannot be used during pregnancy. Chemotherapy may be used in later pregnancy if needed. Treatment plans are always personalised.  

What if you want to become pregnant after breast cancer treatment?

If you are thinking about pregnancy after treatment, watch our recorded Q&A webinar on fertility and breast cancer. Research such as the POSITIVE clinical trial is helping doctors understand how women taking endocrine therapy may safely pause treatment in order to attempt pregnancy under medical supervision. 

Find out more about recent research into interrupting endocrine therapy, to attempt pregnancy after breast cancer. 

Sources:

https://www.cancer.gov/types/breast/breast-cancer-during-pregnancy 

https://www.mdpi.com/1718-7729/31/4/171 

https://www.cancer.nsw.gov.au/about-cancer/document-library/gestational-breast-cancer-in-new-south-wales-a-pop

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Don’t miss an opportunity to stay informed about the latest in breast cancer research and care. Join our FREE Q&A webinars, where we cover important topics including whether more young women are being diagnosed with breast cancer.

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