Cancer in pregnancy: diagnosis, treatment and neonatal outcome

The estimated incidence of cancer diagnosed in pregnant women in developed societies is 1:1000 pregnancies. The most common cancers associated with pregnancy are gynecological, breast, hematological, and skin. A multidisciplinary care team is required. Various treatment modalities are used, including surgical intervention, chemotherapy and radiological. The management of the malignant condition should be standardized, similarly to management offered without pregnancy. Hormone therapy and chemotherapy in the first trimester, and radiotherapy are most contra-indicated. The delivery term depends on the date of discovery of cancer, but is beyond 35 weeks of gestation in the majority of cases, to minimize fetal or obstetrical risks. Pregnancy does not have a deleterious effect on the prognosis of cancers generally, but it is often associated with a delay in diagnosis. Malignant disease management and feto-maternal outcome are described in the present review and particular attention is focused on the treatment effects.