The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation

Adriana Valentini, Jan Lubinski, Tomasz Byrski, Parviz Ghadirian, Pal Moller, Henry T. Lynch, Peter Ainsworth, Susan L. Neuhausen, Jeffrey Weitzel, Christian F. Singer, Olufunmilayo I. Olopade, Howard Saal, Dominique Stoppa Lyonnet, William D. Foulkes, Charmaine Kim-Sing, Siranoush Manoukian, Dana Zakalik, Susan Armel, Leigha Senter, Charis EngEva Grunfeld, Anna M. Chiarelli, Aletta Poll, Ping Sun, Steven A. Narod

Research output: Contribution to journalArticle

Abstract

Physicians are often approached by young women with a BRCA mutation and a recent history of breast cancer who wish to have a baby. They wish to know if pregnancy impacts upon their future risks of cancer recurrence and survival. To date, there is little information on the survival experience of women who carry a mutation in one of the BRCA genes and who become pregnant. From an international multi-center cohort study of 12,084 women with a BRCA1 or BRCA2 mutation, we identified 128 case subjects who were diagnosed with breast cancer while pregnant or who became pregnant after a diagnosis of breast cancer. These women were age-matched to 269 mutation carriers with breast cancer who did not become pregnant (controls). Subjects were followed from the date of breast cancer diagnosis until the date of last follow-up or death from breast cancer. The Kaplan-Meier method was used to estimate 15-year survival rates. The hazard ratio for survival associated with pregnancy was calculated using a left-truncated Cox proportional hazard model, adjusting for other prognostic factors. Among women who were diagnosed with breast cancer when pregnant or who became pregnant thereafter, the 15-year survival rate was 91.5 %, compared to a survival of 88.6 % for women who did not become pregnant (adjusted hazard ratio = 0.76; 95 % CI 0.31-1.91; p = 0.56). Pregnancy concurrent with or after a diagnosis of breast cancer does not appear to adversely affect survival among BRCA1/2 mutation carriers.

Original languageEnglish
Pages (from-to)177-185
Number of pages9
JournalBreast Cancer Research and Treatment
Volume142
Issue number1
DOIs
Publication statusPublished - Nov 2013

Keywords

  • BRCA1
  • BRCA2
  • Breast cancer
  • Pregnancy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Valentini, A., Lubinski, J., Byrski, T., Ghadirian, P., Moller, P., Lynch, H. T., Ainsworth, P., Neuhausen, S. L., Weitzel, J., Singer, C. F., Olopade, O. I., Saal, H., Lyonnet, D. S., Foulkes, W. D., Kim-Sing, C., Manoukian, S., Zakalik, D., Armel, S., Senter, L., ... Narod, S. A. (2013). The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation. Breast Cancer Research and Treatment, 142(1), 177-185. https://doi.org/10.1007/s10549-013-2729-1