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

METHODS:

• Multicenter, retrospective cohort study (January 2000 and December 2012
• Participants
  • Breast cancer diagnosis  ≤ 40 years
  • Deleterious germline BRCA mutations
• Exposures
  • Pregnancy after breast cancer
  • No pregnancy
• Study design
  • 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
• Primary outcomes
  • Pregnancy rate
  • Disease-free survival (DFS)
• Secondary outcomes
  • Pregnancy outcomes
  • Overall survival (OS)

RESULTS:

• 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 outcomes
  • Pregnancy rate at 10 years: 19% (95% CI, 17% to 22%)
  • Induced abortions: 8.2%
  • Miscarriages: 10.3%
  • Births: 76.9% of women | 9.2% preterm
  • Adverse outcomes
    • 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
  • Overall survival
    • Adjusted HR 0.88 (95% CI, 0.50 to 1.56)
    • P = 0.66

CONCLUSION:

• 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
• The authors conclude that

These findings are of paramount importance for health care providers involved in counseling young patients with BRCA-mutated breast cancer who inquire about the feasibility and safety of future conception

Learn More – Primary Sources:

Pregnancy After Breast Cancer in Patients With Germline BRCA Mutations

Related ObG Topics:

Does Pregnancy Increase Risk of Breast Cancer?

BRCA1 & BRCA2 Mutations: What Are the Risks for Developing Breast and Ovarian Cancer?

For Women with A Personal History of Breast Cancer: Mammography or Breast MRI?