With fertility now possible at a later age, women find themselves at an increased risk for concurrent breast cancer diagnosis. Due to the teratogenic effects of most chemotherapeutic agents, difficult decisions must be made regarding the best outcomes for both mother and baby. Depending on the stage of their cancer, the gestational age of the fetus, and the timing of the diagnosis, women must choose between a therapeutic abortion, safer surgical modalities, a modified treatment plan beginning in the second or third trimester, or postponement of the treatment until the baby is born. Oncology and OB/GYN nurses need to be aware of these complex cases and offer advanced support and care to meet the needs of their patients.