ABSTRACT
Management of thyroid cancer in pregnancy is challenging and mandates a multidisciplinary team approach with thorough counseling of the mother and family. Differentiated thyroid cancer is the second most common type of cancer diagnosed in pregnancy. Apart from established risk factors of childhood radiation and family history of thyroid cancer, increased thyroid cancer risk with multiparity suggests the role of estrogen and other pregnancy hormones in pathogenesis. High-resolution ultrasound of the thyroid and neck is the safest imaging modality in pregnancy. Surgery can usually be deferred until after delivery and is largely reserved for aggressive or rapidly growing thyroid cancer. Whether thyroidectomy is performed or deferred, thyroid-stimulating hormone suppression is recommended. Diagnostic and therapeutic radioactive iodine (RAI) therapy is contraindicated in pregnancy. Breastfeeding should be stopped 2–3 weeks prior to RAI treatment and not be resumed for the current lactation period.
