Pregnancy After Breast Cancer in Patients With Germline BRCA Mutations
| Autor: | Alberta Ferrari, Lucia Del Mastro, Albert Grinshpun, Amir Sonnenblick, Sileny Han, Matteo Lambertini, Philip D. Poorvu, Jose Alejandro Perez-Fidalgo, Fedro A. Peccatori, Rossella Graffeo, Riccardo Ponzone, Hatem A. Azim, Shani Paluch-Shimon, Luca Livraghi, Luis Augusto Teixeira, Olivier Caron, Maria Vittoria Dieci, Anne-Sophie Hamy, Michail Ignatiadis, Estela Carrasco, Laura De Marchis, Gianmaria Miolo, Claire Senechal, Martine Berlière, Christine Rousset-Jablonski, Katarzyna Pogoda, Octavi Cordoba, Cynthia Villarreal-Garza, Anna Zingarello, Helena Luna Pais, Laura Cortesi, Claire Saule, Lieveke Ameye, Florian Clatot, Maria Del Pilar Estevez-Diz, Marianne Paesmans, Ann H. Partridge |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Breast surgery medicine.medical_treatment Germline 03 medical and health sciences 0302 clinical medicine Germline mutation Breast cancer Internal medicine medicine skin and connective tissue diseases breast canceri Pregnancy business.industry Case-control study medicine.disease BRCA2 Protein 030104 developmental biology pregnancy brca 030220 oncology & carcinogenesis business Tamoxifen medicine.drug |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.19.02399 |
| Popis: | PURPOSE Young women with germline BRCA mutations have unique reproductive challenges. Pregnancy after breast cancer does not increase the risk of recurrence; however, very limited data are available in patients with BRCA mutations. This study investigated the impact of pregnancy on breast cancer outcomes in patients with germline BRCA mutations. PATIENTS AND METHODS This is an international, multicenter, hospital-based, retrospective cohort study. Eligible patients were diagnosed between January 2000 and December 2012 with invasive early breast cancer at age ≤ 40 years and harbored deleterious germline BRCA mutations. Primary end points were pregnancy rate, and disease-free survival (DFS) between patients with and without a pregnancy after breast cancer. Pregnancy outcomes and overall survival (OS) were secondary end points. Survival analyses were adjusted for guarantee-time bias controlling for known prognostic factors. RESULTS Of 1,252 patients with germline BRCA mutations ( BRCA1, 811 patients; BRCA2, 430 patients; BRCA1/2, 11 patients) included, 195 had at least 1 pregnancy after breast cancer (pregnancy rate at 10 years, 19%; 95% CI, 17% to 22%). Induced abortions and miscarriages occurred in 16 (8.2%) and 20 (10.3%) patients, respectively. Among the 150 patients who gave birth (76.9%; 170 babies), pregnancy complications and congenital anomalies occurred in 13 (11.6%) and 2 (1.8%) cases, respectively. Median follow-up from breast cancer diagnosis was 8.3 years. No differences in DFS (adjusted hazard ratio [HR], 0.87; 95% CI, 0.61 to 1.23; P = .41) or OS (adjusted HR, 0.88; 95% CI, 0.50 to 1.56; P = .66) were observed between the pregnancy and nonpregnancy cohorts. CONCLUSION Pregnancy after breast cancer in patients with germline BRCA mutations 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. |
| Databáze: | OpenAIRE |
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