Pregnancy after breast cancer in patients with germline BRCA mutations

Matteo, Md, Phd Lambertini; Lieveke, Msc, Phd Ameye; Anne Sophie, Md, Phd Hamy; Anna, Md Zingarello; Philip D.,md Poorvu; Estela, Msc Carrasco; Albert, Md, Msc Grinshpun; Sileny, Md Han; Christine, Md, Phd Rousset-Jablonski; Alberta, Md Ferrari; Shani, Mbbs, Msc Paluch-Shimon; Laura, Md Cortesi; Claire, Md Senechal; Gianmaria, Md Miolo; Katarzyna, Md Pogoda; Jose Alejandro, Md, Phd Pérez-Fidalgo; Laura, Md De Marchis; Riccardo, Md, Phd Ponzone; Luca, Md Livraghi; Maria, Md, Phd Del Pilar Estevez-Diz; Cynthia, Md, Phd Villarreal-Garza; Maria Vittoria, Md Dieci; Florian, Md, Phd Clatot; Martine, Md, Phd Berlière; Rossella, Md Graffeo; Luis, Md, Phd Teixeira; Octavi, Md, Phd Córdoba; Amir, Md, Phd Sonnenblick; Helena Luna, Md Pais; Michail, Md, Phd Ignatiadis; Marianne, Msc Paesmans; Ann H.,.Md, Mph Partridge; Olivier, Md, Msc Caron; Claire, Md, Msc Saule; Lucia, Md Del Mastro; Fedro A.,.Md, Phd Peccatori; Hatem A. Azim

doi:10.1200/JCO.19.02399

Pregnancy after breast cancer in patients with germline BRCA mutations

Matteo, Md, Phd Lambertini, Lieveke, Msc, Phd Ameye, Anne Sophie, Md, Phd Hamy, Anna, Md Zingarello, Philip D.,md Poorvu, Estela, Msc Carrasco, Albert, Md, Msc Grinshpun, Sileny, Md Han, Christine, Md, Phd Rousset-Jablonski, Alberta, Md Ferrari, Shani, Mbbs, Msc Paluch-Shimon, Laura, Md Cortesi, Claire, Md Senechal, Gianmaria, Md Miolo, Katarzyna, Md Pogoda, Jose Alejandro, Md, Phd Pérez-Fidalgo, Laura, Md De Marchis, Riccardo, Md, Phd Ponzone, Luca, Md Livraghi, Maria, Md, Phd Del Pilar Estevez-DizCynthia, Md, Phd Villarreal-Garza, Maria Vittoria, Md Dieci, Florian, Md, Phd Clatot, Martine, Md, Phd Berlière, Rossella, Md Graffeo, Luis, Md, Phd Teixeira, Octavi, Md, Phd Córdoba, Amir, Md, Phd Sonnenblick, Helena Luna, Md Pais, Michail, Md, Phd Ignatiadis, Marianne, Msc Paesmans, Ann H.,.Md, Mph Partridge, Olivier, Md, Msc Caron, Claire, Md, Msc Saule, Lucia, Md Del Mastro, Fedro A.,.Md, Phd Peccatori, Hatem A. Azim

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Résumé

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 guaranteetime 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; P5.41) 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.

langue originale	Anglais
Pages (de - à)	3012-3023
Nombre de pages	12
journal	Journal of Clinical Oncology
Volume	38
Numéro de publication	26
Les DOIs	https://doi.org/10.1200/JCO.19.02399
état	Publié - 10 sept. 2020

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10.1200/JCO.19.02399

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Lambertini, M. M. P., Ameye, L. M. P., Hamy, A. S. M. P., Zingarello, A. M., Poorvu, P. D. ., Carrasco, E. M., Grinshpun, A. M. M., Han, S. M., Rousset-Jablonski, C. M. P., Ferrari, A. M., Paluch-Shimon, S. M. M., Cortesi, L. M., Senechal, C. M., Miolo, G. M., Pogoda, K. M., Pérez-Fidalgo, J. A. M. P., De Marchis, L. M., Ponzone, R. M. P., Livraghi, L. M., ... Azim, H. A. (2020). Pregnancy after breast cancer in patients with germline BRCA mutations. Journal of Clinical Oncology, 38(26), 3012-3023. https://doi.org/10.1200/JCO.19.02399

@article{f0a4959fb4dc4dd2978c7f0afd63fb92,

title = "Pregnancy after breast cancer in patients with germline BRCA mutations",

abstract = "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 guaranteetime 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; P5.41) 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.",

author = "Lambertini, {Matteo, Md, Phd} and Ameye, {Lieveke, Msc, Phd} and Hamy, {Anne Sophie, Md, Phd} and Zingarello, {Anna, Md} and Poorvu, {Philip D.,md} and Carrasco, {Estela, Msc} and Grinshpun, {Albert, Md, Msc} and Han, {Sileny, Md} and Rousset-Jablonski, {Christine, Md, Phd} and Ferrari, {Alberta, Md} and Paluch-Shimon, {Shani, Mbbs, Msc} and Cortesi, {Laura, Md} and Senechal, {Claire, Md} and Miolo, {Gianmaria, Md} and Pogoda, {Katarzyna, Md} and P{\'e}rez-Fidalgo, {Jose Alejandro, Md, Phd} and {De Marchis}, {Laura, Md} and Ponzone, {Riccardo, Md, Phd} and Livraghi, {Luca, Md} and {Del Pilar Estevez-Diz}, {Maria, Md, Phd} and Villarreal-Garza, {Cynthia, Md, Phd} and Dieci, {Maria Vittoria, Md} and Clatot, {Florian, Md, Phd} and Berli{\`e}re, {Martine, Md, Phd} and Graffeo, {Rossella, Md} and Teixeira, {Luis, Md, Phd} and C{\'o}rdoba, {Octavi, Md, Phd} and Sonnenblick, {Amir, Md, Phd} and Pais, {Helena Luna, Md} and Ignatiadis, {Michail, Md, Phd} and Paesmans, {Marianne, Msc} and Partridge, {Ann H.,.Md, Mph} and Caron, {Olivier, Md, Msc} and Saule, {Claire, Md, Msc} and {Del Mastro}, {Lucia, Md} and Peccatori, {Fedro A.,.Md, Phd} and Azim, {Hatem A.}",

year = "2020",

month = sep,

day = "10",

doi = "10.1200/JCO.19.02399",

language = "English",

volume = "38",

pages = "3012--3023",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

number = "26",

}

Lambertini, MMP, Ameye, LMP, Hamy, ASMP, Zingarello, AM, Poorvu, PD, Carrasco, EM, Grinshpun, AMM, Han, SM, Rousset-Jablonski, CMP, Ferrari, AM, Paluch-Shimon, SMM, Cortesi, LM, Senechal, CM, Miolo, GM, Pogoda, KM, Pérez-Fidalgo, JAMP, De Marchis, LM, Ponzone, RMP, Livraghi, LM, Del Pilar Estevez-Diz, MMP, Villarreal-Garza, CMP, Dieci, MVM, Clatot, FMP, Berlière, MMP, Graffeo, RM, Teixeira, LMP, Córdoba, OMP, Sonnenblick, AMP, Pais, HLM, Ignatiadis, MMP, Paesmans, MM, Partridge, AHMM, Caron, OMM, Saule, CMM, Del Mastro, LM, Peccatori, FAMP & Azim, HA 2020, 'Pregnancy after breast cancer in patients with germline BRCA mutations', Journal of Clinical Oncology, VOL. 38, Numéro 26, p. 3012-3023. https://doi.org/10.1200/JCO.19.02399

TY - JOUR

T1 - Pregnancy after breast cancer in patients with germline BRCA mutations

AU - Lambertini, Matteo, Md, Phd

AU - Ameye, Lieveke, Msc, Phd

AU - Hamy, Anne Sophie, Md, Phd

AU - Zingarello, Anna, Md

AU - Poorvu, Philip D.,md

AU - Carrasco, Estela, Msc

AU - Grinshpun, Albert, Md, Msc

AU - Han, Sileny, Md

AU - Rousset-Jablonski, Christine, Md, Phd

AU - Ferrari, Alberta, Md

AU - Paluch-Shimon, Shani, Mbbs, Msc

AU - Cortesi, Laura, Md

AU - Senechal, Claire, Md

AU - Miolo, Gianmaria, Md

AU - Pogoda, Katarzyna, Md

AU - Pérez-Fidalgo, Jose Alejandro, Md, Phd

AU - De Marchis, Laura, Md

AU - Ponzone, Riccardo, Md, Phd

AU - Livraghi, Luca, Md

AU - Del Pilar Estevez-Diz, Maria, Md, Phd

AU - Villarreal-Garza, Cynthia, Md, Phd

AU - Dieci, Maria Vittoria, Md

AU - Clatot, Florian, Md, Phd

AU - Berlière, Martine, Md, Phd

AU - Graffeo, Rossella, Md

AU - Teixeira, Luis, Md, Phd

AU - Córdoba, Octavi, Md, Phd

AU - Sonnenblick, Amir, Md, Phd

AU - Pais, Helena Luna, Md

AU - Ignatiadis, Michail, Md, Phd

AU - Paesmans, Marianne, Msc

AU - Partridge, Ann H.,.Md, Mph

AU - Caron, Olivier, Md, Msc

AU - Saule, Claire, Md, Msc

AU - Del Mastro, Lucia, Md

AU - Peccatori, Fedro A.,.Md, Phd

AU - Azim, Hatem A.

PY - 2020/9/10

Y1 - 2020/9/10

N2 - 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 guaranteetime 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; P5.41) 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.

AB - 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 guaranteetime 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; P5.41) 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.

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U2 - 10.1200/JCO.19.02399

DO - 10.1200/JCO.19.02399

M3 - Review article

C2 - 32673153

AN - SCOPUS:85090238406

SN - 0732-183X

VL - 38

SP - 3012

EP - 3023

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 26

ER -