Preinvasive and invasive breast and cervical cancer prior to or during pregnancy

Cancer complicates pregnancy more frequently than appendicitis, thyrotoxicosis, nephrolithiasis, and even deep venous thrombosis.(22) It has been estimated that one out of 1000 pregnant women will be affected by some type of malignancy.(28) Although most malignant neoplasms have their peak incidence beyond the reproductive years, the Third National Cancer Survey reported that 13% of all cancers in women occurred in the 15 to 34 age group.(93) Cancer is the second most common cause of death among women aged 15 to 54 and is the leading cause of death among women aged 35 to 54.(105) Pregnancy neither predisposes women to nor protects them from the development of cancer; therefore, the most frequently encountered malignancies during pregnancy are similar to those found in nonpregnant women of similar ages.(70) The most frequently diagnosed malignancies during pregnancy are listed in Table 1. Because pregnancy-associated malignancies are fairly uncommon and generally unsuspected, some obstetricians may not be fully prepared to deal with these situations when they arise. Cancer complicating pregnancy evokes a great deal of fear and anxiety in both the patient and her physician. This largely is due to a lack of information regarding cancers diagnosed during pregnancy. Concerns surround not only the life and well-being of the mother, but also the safety and viability of her fetus. Questions arise regarding the risks to the mother and to the fetus from various diagnostic techniques (especially radiation exposure) and from the treatment modalities available-chemotherapy, radiation, and surgery.