Pregnancy after breast cancer safe for women with germline BRCA mutations
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Pregnancy after breast cancer appeared safe for women with germline BRCA mutations and did not appear to worsen maternal prognosis, according to results of a retrospective study published in Journal of Clinical Oncology.
Researchers also observed favorable fetal outcomes.
The findings should give reassurance to women with BRCA-mutated breast cancer who are interested in future pregnancy, researchers noted.
“Future family planning represents a priority area of concern for a signicant proportion of young women with newly diagnosed breast cancer,” Matteo Lambertini, MD, PhD, adjunct professor and consultant in medical oncology at IRCCS Policlinico San Martino Hospital of University of Genova in Italy, and colleagues wrote. “As a consequence of the current trend toward delaying childbearing, increasing numbers of young patients are diagnosed before the completion of their reproductive plans.”
Previous studies have shown pregnancy after breast cancer does not increase risk for disease recurrence. However, limited data exist on outcomes among women with BRCA mutations.
Lambertini and colleagues sought to evaluate the impact of pregnancy on breast cancer outcomes among 1,252 women with germline BRCA mutations (BRCA1, n = 811; BRCA2, n = 430; BRCA1 and BRCA2, n = 11) who had been diagnosed between 2000 and 2012 with invasive early breast cancer at age 40 years or younger.
Pregnancy rate and DFS between women with and without a pregnancy after breast cancer served as the study’s primary endpoints. Secondary endpoints included pregnancy outcomes and OS.
Researchers adjusted survival analyses for guarantee time bias controlling for known prognostic factors.
Among all women in the study, 195 had at least one pregnancy after breast cancer, for a pregnancy rate at 10 years of 19% (95% CI, 17-22). Pregnancies occurred a median 4.5 years (interquartile range [IQR], 3.1-6.7) following breast cancer diagnosis. Median age at time of pregnancy was 35.7 years (IQR, 32.9-38.6).
Sixteen (8.2%) of the women underwent an abortion, whereas 20 (10.3%) had miscarriages.
Among the 150 women (76.9%) who gave birth to 170 total babies, 13 experienced pregnancy complications, with congenital anomalies reported in two cases.
Median follow-up from breast cancer diagnosis was 8.3 years.
Results showed no differences in DFS (adjusted HR [aHR]= 0.87; 95% CI, 0.61-1.23) or OS (aHR = 0.88; 95% CI, 0.5-1.56) between pregnant and nonpregnant women.
“To our knowledge, this is the largest study to date specically designed to address several unmet questions related to the safety of pregnancy after breast cancer in patients with germline BRCA mutations and their reproductive outcomes,” Lambertini and colleagues wrote. “We observed that pregnancy after breast cancer 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.”
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