1. Cancer, fertility and pregnancy: ESMO Clinical Recommendations for diagnosis, treatment and follow-up
- Author
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Pentheroudakis, George, Pavlidis, Nicholas, Castiglione, M., Pavlidis, Nicholas [0000-0002-2195-9961], and Pentheroudakis, George [0000-0002-6632-2462]
- Subjects
Reproductive toxicity ,Spinal tap ,Alkylating agent ,Cancer therapy ,Drug exposure ,medicine.medical_treatment ,Infertility, Female/chemically induced/diagnosis/therapy ,Neoplasms/complications/diagnosis/*therapy ,Carboplatin ,Breast cancer ,Opiate ,Pregnancy ,Prenatal exposure ,Aspiration biopsy ,Antineoplastic agents ,Pathology ,Anthracycline derivative ,Melphalan ,Melanoma ,Societies, Medical ,Etoposide ,Mercaptopurine ,Incidence ,Radiation hazard ,film.actor ,Oxaliplatin ,Nuclear magnetic resonance imaging ,Paracetamol ,Oncology ,Vincristine ,Dactinomycin ,Bisphosphonic acid derivative ,Rituximab ,Infertility, Female ,Treatment indication ,Human ,Mammography ,Analgesic agent ,Drug megadose ,Ionizing radiation ,Practice guideline ,medicine.medical_specialty ,Health Planning Guidelines ,Antineoplastic Agents ,Physical examination ,Irinotecan ,Pregnancy termination ,Article ,Europe/epidemiology ,Bleomycin ,Antiinflammatory agent ,Medical ,Humans ,Ifosfamide ,Cyclophosphamide ,Cancer staging ,Pregnancy Complications, Neoplastic/diagnosis/*therapy ,Abortion ,Antineoplastic Agents/adverse effects ,Follow up ,medicine.disease ,Radiation therapy ,Methotrexate ,Gonadotoxicity ,film ,Procarbazine ,Chlorambucil ,Echography ,Cisplatin ,Cancer incidence ,Vinca alkaloid ,Lymphoma ,Fertility/drug effects ,Social support ,Fludarabine ,Teratogenicity ,Neoplasms ,Female fertility ,Priority journal ,Risk assessment ,medicine.diagnostic_test ,Radiation dose ,Therapy delay ,Radiation exposure ,Cytarabine ,Cancer diagnosis ,Hematology ,Gynecologic disease ,Ondansetron ,Europe ,Dacarbazine ,Treatment Outcome ,Fine-needle aspiration ,Female ,Fluorouracil ,Radiology ,Thorax radiography ,Uterine cervix cancer ,Societies, Medical/*standards ,Pregnancy Complications, Neoplastic ,Metoclopramide ,Health planning guidelines ,Follow-up studies ,Vinblastine ,Oligohydramnios ,Pregnancy complication ,Biopsy ,Computer assisted tomography ,medicine ,Busulfan ,Cytokine ,Neoplasm Staging ,Cryopreservation ,Neoplastic ,Acute leukemia ,business.industry ,Lymphocytopenia ,Chlormethine ,Pregnant woman ,Taxane derivative ,Trastuzumab ,Medical society ,Surgery ,Malignant neoplastic disease ,Fertility ,Pregnancy complications ,Doxorubicin ,Infertility ,Neoplasm staging ,Prednisone ,Unindexed drug ,Societies ,business ,Thiotepa ,Follow-Up Studies - Abstract
The diagnostic work-up should include a thorough physical examination, including the pelvis, breasts, lymph nodes, skin and should limit unnecessary exposure to ionizing radiation. Fine needle aspiration, core needle or open excisional biopsies are safe to perform. Chest X-ray and mammography with abdominal shielding and ultrasonic examinations are the cornerstone of a basic staging, supplemented by MRI scans in the second/third trimesters when needed [IV, B]. In view of the theoretical risk of fetal heating/cavitation, first trimester MRI scans should be done sparingly and the potentially teratogenic gadolinium should not be administered [V, D]. Computerized tomography or radioisotope studies should be avoided. Minor staging procedures (spinal tap, bone marrow biopsy, endoscopies) are relatively safe to perform [IV, B].
- Published
- 2009