Breast cancer survivors
People with a genetic mutation linked to cancer risk
Triple negative breast cancer
Women under 45
New research shows that pregnancy after breast cancer is safe for women with BRCA mutations and their babies. (9/4/19)
|At a glance||Questions for your doctor|
|Guidelines||Resources and references|
Safety and pregnancy outcomes for women with a BRCA mutations who become pregnant after breast cancer.
There is very little data on the safety of pregnancy and reproductive outcomes (the health of baby and mother) following a breast cancer diagnosis in young BRCA-mutation carriers. This large study addressed this important, unmet medical need.
This study included patients with early-stage, invasive breast cancer (stages I, II, or III). All participants were 40 years old or younger and carried a BRCA mutation. Most (95%) were treated with chemotherapy.
The researchers looked at the mother’s health (pregnancy rate, disease-free status and overall survival) as well as the baby’s health. They found that:
150 (76.9%) patients conceived. For the 112 patients with pregnancy outcome data
If you are a young breast cancer patient with a BRCA mutation and early-stage disease, it is important for you to know that pregnancy after treatment is considered safe. Although there are no national guidelines outlining how long to wait, most oncologists recommend waiting a specified period of time after treatment ends before getting pregnant. This study showed that pregnancy after breast cancer in BRCA mutation carriers does not appear to negatively affect the baby’s health or the mother’s prognosis. These results should reassure breast cancer survivors with a BRCA mutation who are interested in future family planning.
The National Comprehensive Cancer Network (NCCN) has guidelines for oncologists treating young adult women with cancer:
The following clinical trials on cancer patient care are recruiting participants:
Several misconceptions concerning fertility preservation and pregnancy-related issues in breast cancer patients with BRCA mutations persist, even among health care providers who provide breast cancer care. For example, a study of physicians’ knowledge and practices towards fertility and pregnancy-related issues in young breast cancer patients showed that 45% of physicians did not believe pregnancy after breast cancer was safe for patients with a BRCA mutation.
Following a breast cancer diagnosis, BRCA mutation carriers have a narrow window for pregnancy—this is often when they are considering risk-reducing salpingo oophorectomy and may also face a decreased ovarian reserve. Focused research efforts can help in two areas: first, to address these patient issues and second, to improve physicians’ knowledge about post-treatment pregnancy for BRCA carriers and improve their awareness of available guidelines.
About the safety of pregnancy and reproductive outcomes for patients with a BRCA mutation with prior breast cancer history.
This study enrolled patients with early-stage, invasive breast cancer (stages, I, II or III) between January 2000 and December 2012. All patients were ≤40 years old and had a germline (inherited) BRCA mutation.
Of the 1,252 study participants, 811 had a BRCA1 germline mutation, 430 had a mutation in BRCA2, and 11 had a germline mutation in both BRCA1 and BRCA2. Most patients (95%) were treated wtih chemotherapy that consisted of anthracycline- and/or taxane-based regimens.
This was a retrospective, hospital-based study. Primary endpoints in this study were pregnancy rate and disease-free survival; secondary endpoints included overall survival and pregnancy outcomes.
Following a breast cancer diagnosis, 195 (16%) patients in this study became pregnant. Of these, 16 (8.2%) had an induced abortion and 20 (10.3%) had a spontaneous abortion.
Pregnant patients were younger and had more ER-negative tumors.
Of note, the rate of pregnancy and fetal complications observed in this study are similar to those observed for the general population.
Limitations of this study include:
This is the largest study to look at the safety of pregnancy and reproductive outcomes for breast cancer patients with a BRCA mutation. For these patients, pregnancy following breast cancer is safe, particularly for patients with a BRCA1 mutation. Pregnancy does not appear to worsen fetal outcomes or maternal prognosis. This study provides reassurance to breast cancer patients who have a BRCA mutation and are interested in future family planning.
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