Melanoma in pregnancy: a case report and review of the literature

Wielowieyska-Szybińska, Dorota; Spałkowska, Magdalena; Wojas‐Pelc, Anna

doi:10.5114/pdia.2014.44006

Cited by 14 publications

(17 citation statements)

References 35 publications

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“…3 Cut-off points for quartiles were 111 kF, 116 kF, and 158 kF for income; 158 cm, 161 cm, and 165 cm for height; and 2.4kJ/m 2 , 2.5kJ/m 2 , and 2.7kJ/m 2 for residential UV exposure (daily UV doses) in places of birth and of residence at inclusion. 4 At the end of follow-up. 5 Reported in 2000.…”

Section: Resultsmentioning

confidence: 99%

“…Several case reports suggested rapid progression and bad prognosis of melanomas diagnosed during pregnancy. [1][2][3][4][5][6] Sex hormones have been shown to influence pigmentation, 7 one example in humans being the occurrence of hyperpigmentation on the face (melasma) after large hormonal exposures (pregnancy or hormonal treatment use). 8,9 From an epidemiologic point of view, the incidence of melanoma is higher in women than in men in Europe, particularly before age 55, 10 and women with melanoma were reported to have higher survival rates, with consistently lower risks of mortality and metastasis than men, [11][12][13][14] regardless of body site, histologic type, or tumor stage.…”

Section: Introductionmentioning

confidence: 99%

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Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study

Cervenka

Rahmoun

Mahamat‐Saleh

et al. 2019

Intl Journal of Cancer

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Cutaneous melanoma has been suspected to be influenced by female hormones. Several studies reported a positive association between menopausal hormone therapy (MHT) use and melanoma risk; however, previous findings were conflicting. We sought to explore the associations between MHT use and melanoma risk in a prospective cohort of women in France, where a particularly wide variety of MHT formulations are available. E3N is a prospective cohort of 98,995 French women aged 40–65 years in 1990. MHT use was assessed through biennial self‐administered questionnaires. We used Cox proportional hazards regression models adjusted for age and skin cancer risk factors. Over 1990–2008, 444 melanoma cases were ascertained among 75,523 postmenopausal women. Ever use of MHT was associated with a higher melanoma risk (hazard ratio (HR) = 1.35, 95% confidence intervals (CI) = 1.07–1.71). The association was strongest among past users (HR = 1.55, CI = 1.17–2.07, homogeneity for past vs. recent use: p = 0.11), and users of MHT containing norpregnane derivatives (HR = 1.59, CI = 1.11–2.27), although with no heterogeneity across types of MHT (p = 0.13). Among MHT users, the association was similar across durations of use. However, a higher risk was observed when treatment onset occurred shortly after menopause (<6 months: HR = 1.55, CI = 1.16–2.07 vs. ≥2 years). Associations between MHT use and melanoma risk were similar after adjustment for UV exposure, although MHT users were more likely to report sunscreen use than nonusers. Our data do not support a strong association between MHT use and melanoma risk. Further investigation is needed to explore potential effect modification by UV exposure on this relationship.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study

Cervenka

Rahmoun

Mahamat‐Saleh

et al. 2019

Intl Journal of Cancer

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“…Evidence suggests that cutaneous melanoma, the most lethal form of skin cancer, may be influenced by sex hormones. The hypothesis was based on several observations: the known influence of sex hormones on pigmentation and melanocytic tumors; 1 the occurrence of melasma and changes in nevus size and pigmentation during pregnancy; 2,3 the suggested progression of melanoma and worse prognosis among pregnant women; [4][5][6][7] the reported associations between reproductive factors 8 or hormone use [9][10][11][12] and melanoma risk; a higher incidence of melanoma among women compared with men in Europe; 13 and the observed "female advantage" with regards to melanoma survival, women being consistently reported to have better survival rates, 14 lower risks of metastasis 15 and lower mortality rates for melanoma than men, 16,17 regardless of body site, histological type or tumor stage. 14,18 Oral hormones are the leading contraception method in industrialized countries, and they represent a significant source of exogenous hormone use.…”

Section: Introductionmentioning

confidence: 99%

Oral contraceptive use and cutaneous melanoma risk: a French prospective cohort study

Cervenka

Mahamat‐Saleh

Savoye

et al. 2018

Intl Journal of Cancer

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Cutaneous melanoma has been suspected to be influenced by female hormones. Several studies reported a positive association between oral contraceptive (OC) use and melanoma risk. However, findings were conflicting and data from large prospective studies are lacking. E3N is a prospective cohort of 98,995 French women aged 40-65 years at inclusion in 1990. Exposure to lifetime OC use was assessed in 1992 and through biennial questionnaire updates. To assess the association between OC use and melanoma risk, we used Cox models adjusted for age, pigmentary traits, residential ultraviolet (UV) exposure in county of birth and at inclusion and family history of skin cancer. Over 1992-2008, 539 melanoma cases were ascertained among 79,365 women. In age-adjusted models, we found a modest positive association between ever use of OCs and melanoma risk (hazard ratio (HR) = 1.18, 95% confidence intervals (CIs) = 0.98-1.42), which was reduced after adjustment (HR = 1.14, 95% CI = 0.95-1.38). The association was stronger in long-term users (duration ≥10 years: HR = 1.33, 95% CI = 1.00-1.75) and in women who used high-estrogen OCs (HR = 1.27, 95% CI = 1.04-1.56). Among users, there was an inverse association with age at first use (p < 0.01), but no evidence of an association with age at last use or time since last use. OC use was positively associated with tanning bed use (OR = 1.14, CI = 1.01-1.29), sunburns (ptrend = 0.5) and sunscreen use (OR = 1.13, CI = 1.00-1.28) since age 25. Overall, our findings do not support a strong association between OC use and melanoma risk and suggest intentional UV exposure in OC users, which supports a potential confusion by UV exposure in this relationship.

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“… 11 Of note, the placenta should always be carefully evaluated for micrometastases, especially in patients with melanoma, which is the most common neoplasm involving the fetus and the placenta. 7 12 …”

Section: General Principles In Managing Pregnant Patients With Cancermentioning

confidence: 99%

Cancer in pregnancy: disentangling treatment modalities

et al. 2016

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Pregnancy-associated cancer constitutes an uncommon and difficult to manage clinical situation. It is defined as the cancer diagnosed from the first day of childbearing to 1 year post partum. Coexistence of cancer with pregnancy adds complexity to treatment recommendations, as both the mother and the fetus may be affected. The optimal therapeutic management of pregnant women with cancer diagnosis should take into account, apart from medical factors, a host of other parameters (ethical, psychological, religious, legal, etc). Unfortunately, this situation becomes more complex as more women delay childbearing, and consequently the incidence of cancer during pregnancy is constantly increasing. This manuscript summarises the general principles in managing pregnant patients with cancer and gives detailed instructions in the management of pregnant patients with breast cancer, ovarian cancer, melanoma, lymphoma, lung cancer, soft-tissue sarcoma and cervical cancer. Of note, management of pregnant women with cancer diagnosis should be performed in specialised centres with experience and all cases should be discussed in multidisciplinary meetings composed of multiple specialists (medical oncologists, obstetricians, surgeons, radiologists and paediatricians).

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Melanoma in pregnancy: a case report and review of the literature

Cited by 14 publications

References 35 publications

Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study

Postmenopausal hormone use and cutaneous melanoma risk: A French prospective cohort study

Oral contraceptive use and cutaneous melanoma risk: a French prospective cohort study

Cancer in pregnancy: disentangling treatment modalities

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