A new study indicated that about 20% of women with BRCA-mutated breast cancer were able to safely become pregnant without worsening of maternal prognosis.
“These results provide reassurance to patients with BRCA-mutated breast cancer who are interested in future fertility,” the study said. “They are also 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.”
In an international analysis that included 1252 women with germline mutations, approximately 1 in 5 (19%) women had at least 1 pregnancy in the 10 years after breast cancer. Pregnancy rate was 16% in women with hormone receptor–positive disease and 21% in those with hormone receptor–negative disease.
The researchers noted that this rate was slightly higher than expected and “may be due to their very young ages at onset of breast cancer as well as the lower proportion of patients with hormone receptor–positive tumors requiring long-term adjuvant endocrine therapy and more often counseled against subsequent pregnancy for fear that high hormonal levels during pregnancy and/or temporary interruption of endocrine therapy could be detrimental to patients’ outcomes.”
Of the 195 patients who became pregnant, 150 (76.9%) gave birth, with 170 babies born. Pregnancy complications occurred in 11.6% and congenital anomalies occurred in 1.8%. Induced abortions occurred in 8.2% of pregnancies and miscarriages in 10.3%.
After a median follow-up of longer than 8 years, there were no differences between those who became pregnant and those who did not for disease-free survival (hazard ratio [HR], 0.87; 95% CI, 0.61-1.23; P =.41) or overall survival (HR, 0.88; 95% CI, 0.50-1.56; P =.66) outcomes.
Lambertini M, Ameye L, Hamy AS, et al. Pregnancy after breast cancer in patients with germline BRCA mutations [published online July 16, 2020]. J Clin Oncol. doi: 10.1200/JCO.19.02399