NEOPLASTIC DISORDERS

Pregnancy-related cancers are malignancies diagnosed during pregnancy or within the first year after birth. The frequency of diagnosis is 17-110/100,000 live births, and this rate is expected to increase in the future due to increasing maternal age. The most common cancers are breast, hematological and cervical cancers. Safe imaging methods for the fetus should be preferred for diagnosis and staging. While ultrasonogra-phy and non-contrast magnetic resonance imaging (MRI) are considered safe, examinations containing ionizing radiation should be used with caution and in limited amounts. Surgical interventions can be performed in all trimesters, but the most appropriate period is the early second trimester gestastional weeks. The physiological changes in pregnancy (increased gastroesopha-geal reflux, maternal hypotension) should be taken into consideration. Laparoscopy is considered safe in experienced hands and with appropriate precautions. Chemotherapy can be applied in the second and third trimesters of pregnancy. Its use in the first trimes-ter is not recommended due to the risk of fetal teratogenicity. Placental passage of chemotherapeutic agents depends on their molecular structures. Treatment doses are recommended the same with non-pregnant patients. Nausea and vomiting can be controlled with ondansetron, metoclopramide or prochlorperazine. Patients should be adequately hydrated during and after chemotherapy. Cervical cancer is the one of the most malignancy during pregnancy. The treatment for cervical cancer is shaped according to the stage, gestational age and the patient’s desire to preserve pregnancy. While conization can be done in microinvasive cancer, neoadjuvant chemotherapy or pregnancy termination may be required in advanced stages. The majority of adnexal masses detected during pregnancy are benign. Malignancy is identified in approximately 1% of cases, and is diagnosed in the early stage. Suspicious adnexal masses during pregnancy should be managed in multidisciplinary centers including gynecologic oncology and peri-natology. Early stages in ovarian cancer treatment is surgical staging, neoadjuvant chemotherapy can be given if the decision to continue the pregnancy is made in advanced stages. Breast cancer is most frequently detected as a palpable breast mass. Ultrasound, as the first-line im-aging modality, is considered safe during pregnancy. The mainstay of treatment is surgery and che-motherapy, whereas radiotherapy is contraindicated during pregnancy and may be deferred until the postpartum period. The most common hematologic malignancies are lymphoma and acute leukemia. Hematological ma-lignancies are rare but have an aggressive course. Diagnosis and treatment should be planned with a multidisciplinary approach, considering maternal-fetal risks.