Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 3012-3023 |
| Number of pages | 12 |
| Journal | J. Clin. Oncol. |
| Volume | 38 |
| Issue number | 26 |
| DOIs | |
| Publication status | Published - 2020 |
Keywords
- anthracycline
- antineoplastic metal complex
- BRCA1 protein
- BRCA2 protein
- hormone receptor
- tamoxifen
- adult
- breast cancer
- breast surgery
- cancer hormone therapy
- case control study
- cohort analysis
- congenital malformation
- disease free survival
- female
- follow up
- germline mutation
- human
- induced abortion
- major clinical study
- mastectomy
- overall survival
- pregnancy
- pregnancy complication
- pregnancy outcome
- pregnancy rate
- priority journal
- retrospective study
- Review
- salpingooophorectomy
- spontaneous abortion
- treatment duration
- treatment outcome
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Pregnancy after breast cancer in patients with germline BRCA mutations : Journal of Clinical Oncology. / Lambertini, M.; Ameye, L.; Hamy, A.-S.; Zingarello, A.; Poorvu, P.D.; Carrasco, E.; Grinshpun, A.; Han, S.; Rousset-Jablonski, C.; Ferrari, A.; Paluch-Shimon, S.; Cortesi, L.; Senechal, C.; Miolo, G.; Pogoda, K.; Pérez-Fidalgo, J.A.; De Marchis, L.; Ponzone, R.; Livraghi, L.; Del Pilar Estevez-Diz, M.; Villarreal-Garza, C.; Dieci, M.V.; Clatot, F.; Berlière, M.; Graffeo, R.; Teixeira, L.; Córdoba, O.; Sonnenblick, A.; Pais, H.L.; Ignatiadis, M.; Paesmans, M.; Partridge, A.H.; Caron, O.; Saule, C.; Del Mastro, L.; Peccatori, F.A.; Azim H.A., Jr.
In: J. Clin. Oncol., Vol. 38, No. 26, 2020, p. 3012-3023.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Pregnancy after breast cancer in patients with germline BRCA mutations
T2 - Journal of Clinical Oncology
AU - Lambertini, M.
AU - Ameye, L.
AU - Hamy, A.-S.
AU - Zingarello, A.
AU - Poorvu, P.D.
AU - Carrasco, E.
AU - Grinshpun, A.
AU - Han, S.
AU - Rousset-Jablonski, C.
AU - Ferrari, A.
AU - Paluch-Shimon, S.
AU - Cortesi, L.
AU - Senechal, C.
AU - Miolo, G.
AU - Pogoda, K.
AU - Pérez-Fidalgo, J.A.
AU - De Marchis, L.
AU - Ponzone, R.
AU - Livraghi, L.
AU - Del Pilar Estevez-Diz, M.
AU - Villarreal-Garza, C.
AU - Dieci, M.V.
AU - Clatot, F.
AU - Berlière, M.
AU - Graffeo, R.
AU - Teixeira, L.
AU - Córdoba, O.
AU - Sonnenblick, A.
AU - Pais, H.L.
AU - Ignatiadis, M.
AU - Paesmans, M.
AU - Partridge, A.H.
AU - Caron, O.
AU - Saule, C.
AU - Del Mastro, L.
AU - Peccatori, F.A.
AU - Azim H.A., Jr.
N1 - Cited By :12 Export Date: 18 February 2021 CODEN: JCOND Correspondence Address: Azim, H.A.; Monterrey Institute of Technology and Higher Education, Ave Morones Prieto 3000, Mexico; email: hatem.azim@gmail.com Chemicals/CAS: tamoxifen, 10540-29-1 Funding details: Conquer Cancer Foundation, CCF Funding details: Breast Cancer Research Foundation, BCRF Funding details: Susan G. Komen, SGK Funding details: Associazione Italiana per la Ricerca sul Cancro, AIRC Funding details: European Society for Medical Oncology, ESMO Funding details: Amis de l'Institut Bordet Funding details: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 531000 Funding text 1: Supported by partial funding from the "Les Amis de l'Institut Bordet" foundation, the Italian Association for Cancer Research (AIRC), and the IRCCS Ospedale Policlinico San Martino (Genoa, Italy) 531000 grant. The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. Funding text 2: M.L. acknowledges support from the European Society for Medical Oncology (ESMO) for a translational research fellowship at the Institut Jules Bordet in Brussels, Belgium, at the time of conduct of this study and the Conquer Cancer Foundation for the 2019 ASCO Sherwin Family Endowed Merit Award to present the results of this study at the 2019 ASCO Annual Meeting. A.H.P. acknowledges support from Susan G. Komen and the Breast Cancer Research Foundation. We thank the following researchers who participated in data collection and/or study management: Francesca Poggio and Eva Blondeaux from IRCCS Ospedale Policlinico San Martino (Genoa, Italy), Ines Vaz Luis from Institut Gustave Roussy (Villejuif, France), Craig Snow from Dana-Farber Cancer Institute (Boston, MA), Judith Balmaña Gelpi and Rebeca Ribas from Vall d’Hebron Institute of Oncology (Barcelona, Spain), Tamar Peretz from Sharett Institute of Oncology Hadassah-Hebrew University Medical Center (Jerusalem, Israel), Patrick Neven and Hans Wildiers from University Hospitals Leuven (Leuven, Belgium), Laurie Denis-Laroque from Centre Léon Bérard (Lyon, France), Solene de Talhouet Funding text 3: Supported by partial funding from the “Les Amis de l’Institut Bordet” foundation, the Italian Association for Cancer Research (AIRC), and the IRCCS Ospedale Policlinico San Martino (Genoa, Italy) 531000 grant. The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. 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Peccatori, FA, Azim, HA, Orecchia, R, Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up (2013) Ann Oncol, 24, pp. vi160-vi170; Paluch-Shimon, S, Cardoso, F, Partridge, AH, ESO-ESMO 4th international consensus guidelines for breast cancer in young women (BCY4) (2020) Ann Oncol, 31, pp. 674-696; Copson, ER, Maishman, TC, Tapper, WJ, Germline BRCA mutation and outcome in young-onset breast cancer (POSH): A prospective cohort study (2018) Lancet Oncol, 19, pp. 169-180; Rosenberg, SM, Ruddy, KJ, Tamimi, RM, BRCA1 and BRCA2 mutation testing in young women with breast cancer (2016) JAMA Oncol, 2, pp. 730-736; Turan, V, Bedoschi, G, Emirdar, V, Ovarian stimulation in patients with cancer: Impact of letrozole and BRCA mutations on fertility preservation cycle outcomes (2018) Reprod Sci, 25, pp. 26-32; Lambertini, M, Goldrat, O, Ferreira, AR, Reproductive potential and performance of fertility preservation strategies in BRCA-mutated breast cancer patients (2018) Ann Oncol, 29, pp. 237-243; Paluch-Shimon, S, Cardoso, F, Sessa, C, Prevention and screening in BRCA mutation carriers and other breast/ovarian hereditary cancer syndromes: ESMO clinical practice guidelines for cancer prevention and screening (2016) Ann Oncol, 27, pp. v103-v110; Lambertini, M, Goldrat, O, Toss, A, Fertility and pregnancy issues in BRCA-mutated breast cancer patients (2017) Cancer Treat Rev, 59, pp. 61-70; Iqbal, J, Amir, E, Rochon, PA, Association of the timing of pregnancy with survival in women with breast cancer (2017) JAMA Oncol, 3, pp. 659-665; Lambertini, M, DiMaio, M, Poggio, F, Knowledge, attitudes and practice of physicians towards fertility and pregnancy-related issues in young BRCA-mutated breast cancer patients (2019) Reprod Biomed Online, 38, pp. 835-844; von Elm, E, Altman, DG, Egger, M, The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies (2007) Lancet, 370, pp. 1453-1457; Giobbie-Hurder, A, Gelber, RD, Regan, MM, Challenges of guarantee-time bias (2013) J Clin Oncol, 31, pp. 2963-2969; Stensheim, H, Cvancarova, M, Møller, B, Pregnancy after adolescent and adult cancer: A population-based matched cohort study (2011) Int J Cancer, 129, pp. 1225-1236; Pagani, O, Azim, H, Pregnancy after breast cancer: Myths and facts (2012) Breast Care (Basel), 7, pp. 210-214; van der Kooi, ALF, Kelsey, TW, van den Heuvel-Eibrink, MM, Perinatal complications in female survivors of cancer: A systematic review and meta-analysis (2019) Eur J Cancer, 111, pp. 126-137; Martin, JA, Hamilton, BE, Osterman, MJ, Births in the United States, 2013 (2014) NCHS Data Brief, 175, pp. 1-8; Gaskins, AJ, Rich-Edwards, JW, Hauser, R, Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth (2014) Obstet Gynecol, 124, pp. 23-31; Dolk, H, Loane, M, Garne, E, The prevalence of congenital anomalies in Europe (2010) Adv Exp Med Biol, 686, pp. 349-364; Massarotti, C, Scaruffi, P, Lambertini, M, Beyond fertility preservation: Role of the oncofertility unit in the reproductive and gynecological follow-up of young cancer patients (2019) Hum Reprod, 34, pp. 1462-1469; Valentini, A, Lubinski, J, Byrski, T, The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation (2013) Breast Cancer Res Treat, 142, pp. 177-185; Mueller, CR, Roskelley, CD, Regulation of BRCA1 expression and its relationship to sporadic breast cancer (2003) Breast Cancer Res, 5, pp. 45-52; Pan, H, He, Z, Ling, L, Reproductive factors and breast cancer risk among BRCA1 or BRCA2 mutation carriers: Results from ten studies (2014) Cancer Epidemiol, 38, pp. 1-8; Friebel, TM, Domchek, SM, Rebbeck, TR, Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: Systematic review and meta-analysis (2014) J Natl Cancer Inst, 106, p. dju091
PY - 2020
Y1 - 2020
N2 - PURPOSE Young women with germline BRCA mutations have unique reproductive challenges. Pregnancy after breast cancer does not increase the risk of recurrence; however, very limited data are available in patients with BRCA mutations. This study investigated the impact of pregnancy on breast cancer outcomes in patients with germline BRCA mutations. PATIENTS AND METHODS This is an international, multicenter, hospital-based, retrospective cohort study. Eligible patients were diagnosed between January 2000 and December 2012 with invasive early breast cancer at age ≤ 40 years and harbored deleterious germline BRCA mutations. Primary end points were pregnancy rate, and disease-free survival (DFS) between patients with and without a pregnancy after breast cancer. Pregnancy outcomes and overall survival (OS) were secondary end points. Survival analyses were adjusted for guaranteetime bias controlling for known prognostic factors. RESULTS Of 1,252 patients with germline BRCA mutations (BRCA1, 811 patients; BRCA2, 430 patients; BRCA1/2, 11 patients) included, 195 had at least 1 pregnancy after breast cancer (pregnancy rate at 10 years, 19%; 95%CI, 17% to 22%). Induced abortions and miscarriages occurred in 16 (8.2%) and 20 (10.3%) patients, respectively. Among the 150 patients who gave birth (76.9%; 170 babies), pregnancy complications and congenital anomalies occurred in 13 (11.6%) and 2 (1.8%) cases, respectively. Median follow-up from breast cancer diagnosis was 8.3 years. No differences in DFS (adjusted hazard ratio [HR], 0.87; 95%CI, 0.61 to 1.23; P5.41) or OS (adjusted HR, 0.88; 95% CI, 0.50 to 1.56; P = .66) were observed between the pregnancy and nonpregnancy cohorts. CONCLUSION Pregnancy after breast cancer in patients with germline BRCA mutations is safe without apparent worsening of maternal prognosis and is associated with favorable fetal outcomes. These results provide reassurance to patients with BRCA-mutated breast cancer interested in future fertility. Copyright © 2020 American Society of Clinical Oncology. All rights reserved.
AB - PURPOSE Young women with germline BRCA mutations have unique reproductive challenges. Pregnancy after breast cancer does not increase the risk of recurrence; however, very limited data are available in patients with BRCA mutations. This study investigated the impact of pregnancy on breast cancer outcomes in patients with germline BRCA mutations. PATIENTS AND METHODS This is an international, multicenter, hospital-based, retrospective cohort study. Eligible patients were diagnosed between January 2000 and December 2012 with invasive early breast cancer at age ≤ 40 years and harbored deleterious germline BRCA mutations. Primary end points were pregnancy rate, and disease-free survival (DFS) between patients with and without a pregnancy after breast cancer. Pregnancy outcomes and overall survival (OS) were secondary end points. Survival analyses were adjusted for guaranteetime bias controlling for known prognostic factors. RESULTS Of 1,252 patients with germline BRCA mutations (BRCA1, 811 patients; BRCA2, 430 patients; BRCA1/2, 11 patients) included, 195 had at least 1 pregnancy after breast cancer (pregnancy rate at 10 years, 19%; 95%CI, 17% to 22%). Induced abortions and miscarriages occurred in 16 (8.2%) and 20 (10.3%) patients, respectively. Among the 150 patients who gave birth (76.9%; 170 babies), pregnancy complications and congenital anomalies occurred in 13 (11.6%) and 2 (1.8%) cases, respectively. Median follow-up from breast cancer diagnosis was 8.3 years. No differences in DFS (adjusted hazard ratio [HR], 0.87; 95%CI, 0.61 to 1.23; P5.41) or OS (adjusted HR, 0.88; 95% CI, 0.50 to 1.56; P = .66) were observed between the pregnancy and nonpregnancy cohorts. CONCLUSION Pregnancy after breast cancer in patients with germline BRCA mutations is safe without apparent worsening of maternal prognosis and is associated with favorable fetal outcomes. These results provide reassurance to patients with BRCA-mutated breast cancer interested in future fertility. Copyright © 2020 American Society of Clinical Oncology. All rights reserved.
KW - anthracycline
KW - antineoplastic metal complex
KW - BRCA1 protein
KW - BRCA2 protein
KW - hormone receptor
KW - tamoxifen
KW - adult
KW - breast cancer
KW - breast surgery
KW - cancer hormone therapy
KW - case control study
KW - cohort analysis
KW - congenital malformation
KW - disease free survival
KW - female
KW - follow up
KW - germline mutation
KW - human
KW - induced abortion
KW - major clinical study
KW - mastectomy
KW - overall survival
KW - pregnancy
KW - pregnancy complication
KW - pregnancy outcome
KW - pregnancy rate
KW - priority journal
KW - retrospective study
KW - Review
KW - salpingooophorectomy
KW - spontaneous abortion
KW - treatment duration
KW - treatment outcome
U2 - 10.1200/JCO.19.02399
DO - 10.1200/JCO.19.02399
M3 - Article
VL - 38
SP - 3012
EP - 3023
JO - J. Clin. Oncol.
JF - J. Clin. Oncol.
SN - 0732-183X
IS - 26
ER -