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Pregnancy After Breast Cancer in BRCA Carriers Found Safe in International Study

In a groundbreaking international hospital-based cohort study involving 4732 BRCA carriers, researchers have found that pregnancy after breast cancer does not pose adverse risks for either maternal or fetal outcomes. The study, conducted at 78 participating centers worldwide, focused on young women with invasive breast cancer who carried germline pathogenic variants in the BRCA1 or BRCA2 genes.

Key Findings:

  • Cumulative Incidence: 22% of young BRCA carriers conceived within 10 years after breast cancer diagnosis.
  • Maternal and Fetal Outcomes: Pregnancy following breast cancer in BRCA carriers was not associated with adverse maternal prognosis or fetal outcomes.
  • Disease-Free Survival: No significant difference in disease-free survival was observed between patients with or without a pregnancy after breast cancer.
  • Secondary Outcomes: Patients who had a pregnancy showed significantly better breast cancer–specific survival and overall survival.

Study Details:

  • Duration: The study included data from patients diagnosed between January 2000 and December 2020, with the last follow-up conducted on February 20, 2023.
  • Pregnancy Rate: The cumulative incidence of pregnancy at 10 years was 22%, with a median time from breast cancer diagnosis to conception of 3.5 years.
  • Safety: Pregnancy was found to be safe in terms of disease-free survival, breast cancer–specific survival, and overall survival.
  • BRCA Gene Differences: While BRCA1 carriers showed reassuring results, caution is needed to counsel BRCA2 carriers, as a possible association with adverse disease-free survival outcomes was observed.

Implications: The study’s results challenge previous concerns about the safety of pregnancy in BRCA carriers after breast cancer treatment. It provides valuable insights for reproductive counseling of young BRCA carriers, highlighting the feasibility and safety of pregnancy in this specific population.

Future Directions: The study emphasizes the need for further research, especially in understanding the impact of specific BRCA genes on reproductive outcomes. The findings also suggest the importance of considering the evolving landscape of breast cancer treatment and its potential impact on fertility.

Conclusion: This international study offers hope to young BRCA carriers who aspire to start a family after overcoming breast cancer, assuring them that pregnancy does not compromise their long-term health outcomes. The results are expected to influence clinical guidance and support personalized counseling for this unique patient population.

Credit: JAMA Network Open, Matteo Lambertini