Diagnostic and Treatment Considerations for Thyroid Cancer in Women of Reproductive Age and the Perinatal Period

• Autores: Evert F.S. van Velsen, Angela M. Leung, Tim I.M. Korevaar
• Localización: Endocrinology and metabolism clinics of North America, ISSN 0889-8529, Vol. 51, Nº. 2, 2022, págs. 403-416
• Idioma: inglés
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• Resumen

  • Any woman of reproductive age diagnosed with thyroid cancer should be offered preconception advice on the risks of thyroid cancer progression or recurrence, or adverse obstetric and/or childhood outcomes, and contraception in cases where thyroid cancer treatment contraindicates pregnancy. For most cases of differentiated thyroid cancer (DTC) in the perinatal period, treatment can be delayed until after delivery. If surgery is recommended during pregnancy, it should be performed in the second trimester. Pregnancy is not associated with clinically meaningful disease progression of previously treated DTC or micropapillary thyroid carcinoma under active surveillance. It is recommended to avoid pregnancy for 6 to 12 months after radioactive iodine treatment. The need for thyroid hormone therapy to achieve a suppressed serum thyrotropin level during pregnancy is based on the DTC’s dynamic risk response, but the harms and benefits of this should be weighed against the risks of adverse pregnancy outcomes.