Is Pregnancy After Breast Cancer Safe for Women with BRCA Mutations?
BACKGROUND AND PURPOSE:
Pregnancy after breast cancer appears to be safe and is not associated with an increased risk of cancer recurrence
However, data are limited regarding pathogenic BRCA variants
Lambertini et al. (Journal of Clinical Oncology, 2020) investigated the impact of pregnancy on breast cancer outcomes in patients with germline BRCA mutations
Multicenter, retrospective cohort study (January 2000 and December 2012
Breast cancer diagnosis ≤ 40 years
Deleterious germline BRCA mutations
Pregnancy after breast cancer
Survival analyses | Adjusted for known prognostic factors including adjusted for age at diagnosis, tumor size, nodal status, hormone receptor status, type of endocrine therapy, breast surgery, and BRCA mutation
Disease-free survival (DFS)
Overall survival (OS)
1252 patients were included
BRCA1: 811 patients
BRCA2: 430 patients
BRCA1/2: 11 patients
Median age at time of pregnancy: 35.7 years | Median time from diagnosis to pregnancy 4.5 years
195 women had at least 1 pregnancy after breast cancer
Pregnancy rate at 10 years: 19% (95% CI, 17% to 22%)
Induced abortions: 8.2%
Births: 76.9% of women | 9.2% preterm
Pregnancy complications: 11.6%
Congenital anomalies: 1.8%
Median follow-up from breast cancer diagnosis was 8.3 years
No differences in survival detected between the pregnancy and nonpregnancy groups
Disease free survival
Adjusted hazard ratio (HR) 0.87 (95% CI, 0.61 to 1.23)
P = 0.41
Adjusted HR 0.88 (95% CI, 0.50 to 1.56)
P = 0.66
Pregnancy after breast cancer in patients with BRCA mutations is not associated with unfavorable survival outcomes or pregnancy outcomes
For women with BRCA mutations, pregnancy after breast cancer is safe and does not worsen prognosis
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