Pregnancy after breast cancer in patients with germline BRCA mutations: Journal of Clinical Oncology

M. Lambertini, L. Ameye, A.-S. Hamy, A. Zingarello, P.D. Poorvu, E. Carrasco, A. Grinshpun, S. Han, C. Rousset-Jablonski, A. Ferrari, S. Paluch-Shimon, L. Cortesi, C. Senechal, G. Miolo, K. Pogoda, J.A. Pérez-Fidalgo, L. De Marchis, R. Ponzone, L. Livraghi, M. Del Pilar Estevez-DizC. Villarreal-Garza, M.V. Dieci, F. Clatot, M. Berlière, R. Graffeo, L. Teixeira, O. Córdoba, A. Sonnenblick, H.L. Pais, M. Ignatiadis, M. Paesmans, A.H. Partridge, O. Caron, C. Saule, L. Del Mastro, F.A. Peccatori, Jr. Azim H.A.

Research output: Contribution to journalArticlepeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)3012-3023
Number of pages12
JournalJ. Clin. Oncol.
Volume38
Issue number26
DOIs
Publication statusPublished - 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

Fingerprint Dive into the research topics of 'Pregnancy after breast cancer in patients with germline BRCA mutations: Journal of Clinical Oncology'. Together they form a unique fingerprint.

Cite this