Gynecologic malignancy in pregnancy

Ji, Yong; Kim, Ki Tae

doi:10.5468/ogs.2013.56.5.289

Cited by 20 publications

(14 citation statements)

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“…In our study, we found that gynecological malignancies accounted for approximately 80% of all malignant diseases with pregnancy during 2008. The most common pregnancy associated malignancies worldwide are cervical cancer, breast cancer, lymphoma, ovarian cancer, and melanoma [ 12 , 14 , 15 ]. Of these, cervical and breast cancers account for 50% of all cancers occurring during pregnancy [ 15 ], which is a lower rate than is seen in the present study (78%).…”

Section: Discussionmentioning

confidence: 99%

“…The most common pregnancy associated malignancies worldwide are cervical cancer, breast cancer, lymphoma, ovarian cancer, and melanoma [ 12 , 14 , 15 ]. Of these, cervical and breast cancers account for 50% of all cancers occurring during pregnancy [ 15 ], which is a lower rate than is seen in the present study (78%). The obstetrician will often have the best opportunity to make the diagnosis of malignancy during pregnancy, so awareness of the associated symptoms is required during regular pre-natal checkups.…”

Section: Discussionmentioning

confidence: 99%

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Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis

Sekiguchi

Kobayashi

Tabata

et al. 2018

BMC Pregnancy Childbirth

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BackgroundMalignancy during pregnancy has become a significant cause of maternal death in developed countries, likely due to both an older pregnant population, and increases of cervical cancer in younger women. Our aim is to investigate the clinical aspects of malignancy during pregnancy in Japan and to use this information to identify opportunities for earlier detection and treatment.MethodsWe provided a questionnaire to 1508 secondary or tertiary care hospitals in Japan. We reviewed the clinical characteristics of cases with malignancy during pregnancy for the period of January to December, 2008. From the 760 institutions which responded, we obtained clinical information for 227 unique cases. The questionnaire provided clinical information, including disease site, pregnancy outcome and how the disease was detected.ResultsThe most common type of malignancy was cervical cancer (n = 162, 71.4%) followed by ovarian (n = 16, 7.0%) and breast cancer (n = 15, 6.6%). Leukemia (n = 7, 3.1%), colon cancer (n = 5, 2.2%), gastric cancer (n = 5, 2.2%), malignant lymphoma (n = 4, 1.8%), thyroid cancer (n = 3, 1.3%), brain cancer (n = 3, 1.3%), endometrial cancer (n = 2, 0.9%), and head and neck cancer (n = 2, 0.9%) accounted for the remaining cases. Overall, gynecological malignancies accounted for 79.3% (95% confidence interval 74.0–84.6) of pregnancy associated malignancies diagnosed in the present study. The majority of cervical cancers, 149 (92.0%) of 162, were diagnosed by a Pap (Papanicolaou) smear during early gestation. Ten (62.5%) of the ovarian cancer cases were diagnosed by ultrasonography during a prenatal checkup or at the time of initial pregnancy diagnosis. Out of 14 breast cancers, only one (7.1%) was diagnosed by screening breast exam.ConclusionsFrom this study, we reaffirm the clear and significant benefits of prenatal checkups starting at an early gestational age for the detection of gynecological cancers during pregnancy. Conversely, breast cancer detection during pregnancy was poor, suggesting new strategies for early identification of this disease are required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis

Sekiguchi

Kobayashi

Tabata

et al. 2018

BMC Pregnancy Childbirth

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“…Once the termination of a pregnancy is adopted, it is possible either on the request of the patient to the end of the first trimester or on the basis of oncological indication to the end of the 24th week of pregnancy [42]. The treatment algorithm of pregnancy-associated breast cancer is summarized in Fig.…”

Section: Treatment Management Of Pabc Patientsmentioning

confidence: 99%

“…Reconstruction operations should be postponed until the period after birth, with respect to pregnancy-related changes in the other breast and the subsequent undesired cosmetic effects [42]. In early BC with clinically negative lymph nodes in the axilla, standard treatment is currently sentinel lymph node biopsy (SLNB).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Current approaches in the clinical management of pregnancy-associated breast cancer—pros and cons

et al. 2018

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Malignancies are one of the leading causes of mortality in women during their reproductive life. Treatment of gynecological malignant tumors during pregnancy is possible but not simple, since it creates a conflict between care of the mother and the fetus. BC is the most prevalent malignancy diagnosed in pregnancy, ranking up to 21% of all pregnancy-related malignancies. Due to its stets increasing prevalence, aggressive cancer subtype, and severe ethical and psychological aspects linked to the disease, experts raise an alarm for an acute necessity to improve the overall management of the PABC-the issue which has strongly motivated our current paper. Comprehensive research data and clinical experience accumulated in recent years have advanced our understanding of the disease complexity. PABC treatment must be individualized with an emphasis on optimal care of the mother, while observing standard treatment protocols with regard to safety of the fetus. Treatment protocols should be elaborated based on the individualized patient profile, bearing in mind the acute danger to the mother, maximizing the therapy efficacy and minimizing harmful effects to the fetus. Complex consulting on treatment options, their impacts on pregnancy and potential teratogenic effects requires tight "doctor-patient" collaboration. Complications that may arise due to the treatment of breast cancer in pregnancy require a multiprofessional expertise including oncologists, neonatologists, perinatologists, obstetricians, teratologists, and toxicologists, and an extensive psychological support throughout the pregnancy and after giving birth. Thereby, specifically psychological aspects of PABC diagnosis and follow-up are frequently neglected, being not yet adequately explored in the entire disease management approach. Herewith, we update the status quo regarding the currently available diagnostic modalities, complex treatment algorithms, and novel clinical approaches which altogether argue for an urgent necessity of a paradigm shift moving away from reactive to predictive, preventive, and personalized medical approach in the overall management of PABC meeting the needs of young populations, persons at high risk, affected patients, and families as the society at large.

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“…Treatment used in patients with cervical cancer diagnosed in the second trimester of pregnancy depends on tumour stage. Cervical cancer diagnosed in the third trimester is an indication for Caesarean section due to foetal maturity, followed by standard therapy [ 42 ].…”

Section: Treatment Of Tumours Occurring During Pregnancymentioning

confidence: 99%

Cancer treatment in pregnant women

Basta

Bąk²,

Roszkowski³

2015

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In general, strategies for the treatment of cancer in pregnancy should not differ significantly from the treatment regimens in non-pregnant women. However, this is difficult due to either the effects of anticancer drugs on the developing foetus or the possibility of long-term complications after the exposure to drugs and radiation.The decision about the introduction and continuation of treatment in the event of pregnancy should be preceded by a detailed analysis of the potential benefits and risks. There are no data to suggest that pregnancy termination alters the biological behaviour of the tumour or patient prognosis in the presence of appropriate antineoplastic therapy. All patients should be given appropriate advice and informed that there are insufficient scientific data to determine any generally accepted consensus. It is very important to always respect the will of the patient, and the moral judgment of the physician should have no impact on the decisions taken by the woman. If the woman decides to undergo active treatment and maintain her pregnancy, it is necessary to carry out consultations with experts in the field appropriate to the type of cancer. This paper presents a basic review of the literature on the targeted therapies currently used in selected cancers diagnosed during pregnancy: breast cancer, cervical cancer, Hodgkin's disease, melanoma, thyroid cancer, ovarian cancer, and colorectal cancer.

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Gynecologic malignancy in pregnancy

Cited by 20 publications

References 99 publications

Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis

Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis

Current approaches in the clinical management of pregnancy-associated breast cancer—pros and cons

Cancer treatment in pregnant women

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