A 30-year-old female presents to clinic with complaints of neck pain. The patient states that she heard her friend had great relief with HVLA treatments. The patient is currently 20 weeks pregnant and recently suffered acute whiplash in a motor vehicle accident. She has a past medical history including rheumatoid arthritis and was previously treated for breast cancer with bilateral mastectomies. Which of the following conditions in this patient represents an absolute contraindication to HVLA treatment?