Radiological staging in pregnant patients with cancer

Woitek, Ramona; Prayer, Daniela; Hojreh, Azadeh; Helbich, T

doi:10.1136/esmoopen-2015-000017

Cited by 24 publications

(28 citation statements)

References 68 publications

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“…A digital bilateral mammography would also be an acceptable exam to be performed from the fetal radiation exposure perspective, because when associated with appropriate shielding, it has a fetal irradiation of approximately 0.004Gy, being the minimum value to induce negative effects to the fetus 100 mGy. 4,7 However, it is noteworthy that the higher the radiological density of the breast, the lower the sensitivity of the mammogram, therefore the choice of breast ultrasound on this study. 2,4 Due to the need for additional studies for the correct staging of the disease, aiming at the correct treatment planning, a breast magnetic resonance imaging was performed and three right-sided adenomegalies were found, suggesting local lymph node involvement.…”

Section: Discussionmentioning

confidence: 82%

“…To date, magnetic resonance imaging (MRI) has not been shown to have any adverse effects on human fetus, confirmed by studies which followed until 9 years after fetal exposure. 7 The potential theoretical teratogenic effects of MRI result from the static magnetic field, which can potentially alter cell migration, proliferation and differentiation and the use of gadolinium which can cross the placenta. 4,7 However, the risk of an incorrect staging is greater than the potential damage to the fetus and can then be performed after the first trimester of pregnancy, i.e.…”

Section: Discussionmentioning

confidence: 99%

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Clinical, histological and radiological findings of invasive ductal carcinoma in a pregnant woman

Noronha¹,

Régis²,

Borges³

2019

IJRRT

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Pregnancy-associated breast cancer is defined as a breast cancer diagnosed during pregnancy or within one year postpartum. It is an under-studied entity, despite its increased incidence due to the tendency to extend the age of the first gestation.The major issue regarding breast cancer in pregnant women is the delay in diagnosis, both due to glandular and ductal hyperplasia typical of pregnancy, as well as the physician's uncertainty about the diagnostic approach, fearing harmful effects on the fetus, thus leading to a worse prognosis. We report the case of a pregnant patient with invasive ductal carcinoma, suspected by palpation during physical examination and confirmed after histological study of the fragment obtained by ultrasound-guided core biopsy, with subsequent staging with magnetic resonance imaging. The purpose of this report was to discuss the correct investigative management of a case of invasive ductal carcinoma associated with pregnancy, aiming at reducing morbidity and mortality.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Clinical, histological and radiological findings of invasive ductal carcinoma in a pregnant woman

Noronha¹,

Régis²,

Borges³

2019

IJRRT

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“…Imaging modalities should be utilised with caution in any pregnant female wishing to carry their pregnancy to term, and a multidisciplinary discussion regarding a cancer staging workup should be considered. When determining imaging modalities for staging, safety of the foetus, likelihood of metastatic disease and the minimal radiation dose to achieve optimal staging accuracy should be considered [25]. With regard to ionising radiation, the concentration of foetal exposure may be 8–25 mGy with CT of the abdomen and pelvis, 0.01–0.66 mGy with CT of the chest and 1.1–9.04 mGy with FDG-PET [25, 26].…”

Section: Discussionmentioning

confidence: 99%

Primary cardiac angiosarcoma diagnosed in the first trimester of pregnancy

Burns

Ahmed

Sunkara

et al. 2019

ecancer

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Primary cardiac angiosarcoma (PCAS) is a malignancy seldom seen in pregnancy. A 23-year-old G1P0 Chinese female was found to have PCAS during her first trimester when she presented with tamponade physiology. The transthoracic echocardiography (TTE) results did not indicate the presence of an intracardiac lesion, and pericardial fluid cytology analysis showed no evidence of malignancy. Cardiac magnetic resonance imaging (CMRI) exhibited a right atrial mass, and tissue biopsy indicated a high-grade angiosarcoma. MRI of the abdomen was suggestive of liver metastasis. She underwent an abortion and was started on combination chemotherapy, with a reduction in both the cardiac and liver masses. In cardiac angiosarcomas, advanced imaging modalities such as MRI should be utilised when there is high clinical suspicion or in the case of pregnancy when trying to minimise foetal harm. Prognosis is poor, and a standardised treatment protocol regardless of pregnancy continues to elude the medical community.

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“…Magnetic resonance imaging (MRI) is regarded as the modality of choice for acquisition of cross sectional imaging, as no studies to date have demonstrated adverse effects on the fetus from MRI (Figure 1) [5]. Gadolinium, which has been shown to have teratogenic effects in animal models, is not recommended for use during pregnancy [6].…”

Section: Diagnosismentioning

confidence: 99%

“…The potential risks of fetal ionizing radiation exposure include risk of fetal death, induction of congenital malformations (including mental retardation) as well as carcinogenic potential for the unborn fetus[5]. There is no dose of ionizing radiation that is considered safe for a developing fetus, however at radiation exposures of less than 5 cGy, the fetus has a low risk of significant developmental abnormalities [8, 9].…”

Section: Diagnosismentioning

confidence: 99%

The Management of Lymphoma in the Setting of Pregnancy

Pinnix

Andraos

Milgrom

et al. 2017

Curr Hematol Malig Rep

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The diagnosis of lymphoma in pregnant patients poses a therapeutic challenge necessitating consideration of the developing fetus without compromise of therapy with curative potential for the mother. The decision to initiate therapy during pregnancy is heavily influenced by fetal, maternal and disease related factors, of which the most influential are the trimester at diagnosis, the stage and aggressiveness of the disease and the presence of life threatening symptoms. Recent data suggest that deferral of therapy until after the 1st trimester is desirable if it is perceived that postponement of therapy will not compromise maternal outcome. For some patients delay of therapy to the post-partum period is feasible.

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Radiological staging in pregnant patients with cancer

Cited by 24 publications

References 68 publications

Clinical, histological and radiological findings of invasive ductal carcinoma in a pregnant woman

Clinical, histological and radiological findings of invasive ductal carcinoma in a pregnant woman

Primary cardiac angiosarcoma diagnosed in the first trimester of pregnancy

The Management of Lymphoma in the Setting of Pregnancy

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