Pregnancy After BRCA-Associated Breast Cancer
Among women carrying germline BRCA pathogenic variants, is pregnancy after breast cancer associated with adverse maternal or fetal outcomes? Young women with breast cancer who have germline pathogenic variants in BRCA1 or BRCA2 face unique challenges regarding fertility. Previous studies demonstrating the feasibility and safety of pregnancy in breast cancer survivors included limited data regarding BRCA carriers.
An international, multicenter, hospital-based, retrospective cohort study was conducted at 78 participating centers worldwide. The study included female participants diagnosed with invasive breast cancer at age 40 years or younger between January 2000 and December 2020 who had a germline pathogenic variant in BRCA1 and/or BRCA2. Last delivery was October 7, 2022; last follow-up was February 20, 2023.
The study, including 4732 BRCA carriers, showed that 1 in 5 patients conceived within 10 years after a breast cancer diagnosis. Pregnancy following breast cancer in BRCA carriers was not associated with adverse maternal prognosis or fetal outcomes. The cumulative incidence of pregnancy after breast cancer and disease-free survival in this large international cohort of young BRCA carriers may inform care for affected patients.
Primary end points were cumulative incidence of pregnancy after breast cancer and disease-free survival. Secondary end points were breast cancer–specific survival, overall survival, pregnancy, and fetal and obstetric outcomes. Pregnancy following breast cancer in BRCA carriers was not associated with decreased disease-free survival.
The importance of aggressive follow-up of cancer patients is again highlighted in this study.
