title: A proposal for the timing of management of patients with melanoma presenting during pregnancy.
abstract: The treatment of melanoma during and immediately after pregnancy poses a significant challenge to surgeons, oncologists, and patients alike. With the overall increase in incidence of melanoma in the United States and worldwide, it is likely that more surgeons will be faced with management decisions regarding pregnant patients with melanoma. We report on five patients who presented to the Yale Melanoma Unit with melanoma during their pregnancy. We propose the management option of resection of the primary tumor under local anesthesia, and postponing of the sentinel lymph node biopsy until after the birth of the child. The completion lymphadenectomy can be performed if these nodes are found to be harboring metastases. We further discuss treatment options and propose an algorithm for management of patients diagnosed with melanoma while pregnant.
authors.affiliation: Section of Plastic Surgery, Department of Surgery, Yale School of Medicine, Yale Melanoma Unit at the Yale Cancer Center, New Haven, CT, USA.
authors.forename: Niclas
authors.initials: N
authors.lastname: Broer
authors.forename: Samuel
authors.initials: S
authors.lastname: Buonocore
authors.forename: Carolyn
authors.initials: C
authors.lastname: Goldberg
authors.forename: Carolyn
authors.initials: C
authors.lastname: Truini
authors.forename: Marc B
authors.initials: MB
authors.lastname: Faries
authors.forename: Deepak
authors.initials: D
authors.lastname: Narayan
authors.forename: Stephan
authors.initials: S
authors.lastname: Ariyan
mesh_terms: D000328:Adult; D000465:Algorithms; D003663:Decision Trees; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D011264:Pregnancy Trimesters; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome