Difficulties with diagnosis of malignancies in pregnancy

Best Pract Res Clin Obstet Gynaecol. 2016 May;33:19-32. doi: 10.1016/j.bpobgyn.2015.10.005. Epub 2015 Oct 19.

Abstract

Diagnosis and staging of cancer during pregnancy may be difficult due to overlap in physical signs, uncertainties on safety and accuracy of diagnostic tests and histopathology in pregnant women. Tumour markers should be used with caution due to pregnancy-induced elevation. Ionizing imaging and staging techniques such as computed tomography (CT) or positron emission tomography (PET) scans and sentinel node procedures are safe during pregnancy when fetal radiation threshold of 100 mGy is maintained. Ionizing imaging techniques can increasingly be avoided with the technical devolvement of non-ionizing techniques such as magnetic resonance imaging (MRI), including whole body MRI and diffusion-weighted imaging, which hold potentially great opportunities for the diagnostic management of pregnant cancer patients. Pathological evaluation and establishing a diagnosis of malignancy can be difficult in pregnant women, and a note to the pathologist of the pregnant status is essential for accurate diagnosis. This chapter will give an overview of possibilities and difficulties in diagnosing pregnant women with cancer.

Keywords: diagnostic imaging; diagnostic tests; neoplasms; pathology; pregnancy.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / blood
  • Biopsy*
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Multimodal Imaging
  • Neoplasm Staging
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnosis*
  • Pregnancy Complications, Neoplastic / diagnostic imaging
  • Pregnancy Complications, Neoplastic / pathology*
  • Radionuclide Imaging
  • Sentinel Lymph Node Biopsy
  • Tomography, X-Ray Computed
  • Ultrasonography

Substances

  • Biomarkers, Tumor