TY - JOUR
T1 - Safety of assisted reproductive techniques in young women harboring germline pathogenic variants in BRCA1/2 with a pregnancy after prior history of breast cancer
AU - Condorelli, M.
AU - Bruzzone, M.
AU - Ceppi, M.
AU - Ferrari, A.
AU - Grinshpun, A.
AU - Hamy, A. S.
AU - de Azambuja, E.
AU - Carrasco, E.
AU - Peccatori, F. A.
AU - Di Meglio, A.
AU - Paluch-Shimon, S.
AU - Poorvu, P. D.
AU - Venturelli, M.
AU - Rousset-Jablonski, C.
AU - Senechal, C.
AU - Livraghi, L.
AU - Ponzone, R.
AU - De Marchis, L.
AU - Pogoda, K.
AU - Sonnenblick, A.
AU - Villarreal-Garza, C.
AU - Córdoba, O.
AU - Teixeira, L.
AU - Clatot, F.
AU - Punie, K.
AU - Graffeo, R.
AU - Dieci, M. V.
AU - Pérez-Fidalgo, J. A.
AU - Duhoux, F. P.
AU - Puglisi, F.
AU - Ferreira, A. R.
AU - Blondeaux, E.
AU - Peretz-Yablonski, T.
AU - Caron, O.
AU - Saule, C.
AU - Ameye, L.
AU - Balmaña, J.
AU - Partridge, A. H.
AU - Azim, H. A.
AU - Demeestere, I.
AU - Lambertini, M.
N1 - Publisher Copyright:
© 2021 The Author(s)
PY - 2021/12
Y1 - 2021/12
N2 - Background: Knowledge is growing on the safety of assisted reproductive techniques (ART) in cancer survivors. No data exist, however, for the specific population of breast cancer patients harboring germline BRCA1/2 pathogenic variants. Patients and methods: This is a multicenter retrospective cohort study across 30 centers worldwide including women diagnosed at ≤40 years with stage I-III breast cancer, between January 2000 and December 2012, harboring known germline BRCA1/2 pathogenic variants. Patients included in this analysis had a post-treatment pregnancy either achieved through use of ART (ART group) or naturally (non-ART group). ART procedures included ovulation induction, ovarian stimulation for in vitro fertilization or intracytoplasmic sperm injection, and embryo transfer under hormonal replacement therapy. Results: Among the 1424 patients registered in the study, 168 were eligible for inclusion in the present analysis, of whom 22 were in the ART group and 146 in the non-ART group. Survivors in the ART group conceived at an older age compared with those in the non-ART group (median age: 39.7 versus 35.4 years, respectively). Women in the ART group experienced more delivery complications compared with those in the non-ART group (22.1% versus 4.1%, respectively). No other apparent differences in obstetrical outcomes were observed between cohorts. The median follow-up from pregnancy was 3.4 years (range: 0.8-8.6 years) in the ART group and 5.0 years (range: 0.8-17.6 years) in the non-ART group. Two patients (9.1%) in the ART group experienced a disease-free survival event (specifically, a locoregional recurrence) compared with 40 patients (27.4%) in the non-ART group. In the ART group, no patients deceased compared with 10 patients (6.9%) in the non-ART group. Conclusion: This study provides encouraging safety data on the use of ART in breast cancer survivors harboring germline pathogenic variants in BRCA1/2, when natural conception fails or when they opt for ART in order to carry out preimplantation genetic testing.
AB - Background: Knowledge is growing on the safety of assisted reproductive techniques (ART) in cancer survivors. No data exist, however, for the specific population of breast cancer patients harboring germline BRCA1/2 pathogenic variants. Patients and methods: This is a multicenter retrospective cohort study across 30 centers worldwide including women diagnosed at ≤40 years with stage I-III breast cancer, between January 2000 and December 2012, harboring known germline BRCA1/2 pathogenic variants. Patients included in this analysis had a post-treatment pregnancy either achieved through use of ART (ART group) or naturally (non-ART group). ART procedures included ovulation induction, ovarian stimulation for in vitro fertilization or intracytoplasmic sperm injection, and embryo transfer under hormonal replacement therapy. Results: Among the 1424 patients registered in the study, 168 were eligible for inclusion in the present analysis, of whom 22 were in the ART group and 146 in the non-ART group. Survivors in the ART group conceived at an older age compared with those in the non-ART group (median age: 39.7 versus 35.4 years, respectively). Women in the ART group experienced more delivery complications compared with those in the non-ART group (22.1% versus 4.1%, respectively). No other apparent differences in obstetrical outcomes were observed between cohorts. The median follow-up from pregnancy was 3.4 years (range: 0.8-8.6 years) in the ART group and 5.0 years (range: 0.8-17.6 years) in the non-ART group. Two patients (9.1%) in the ART group experienced a disease-free survival event (specifically, a locoregional recurrence) compared with 40 patients (27.4%) in the non-ART group. In the ART group, no patients deceased compared with 10 patients (6.9%) in the non-ART group. Conclusion: This study provides encouraging safety data on the use of ART in breast cancer survivors harboring germline pathogenic variants in BRCA1/2, when natural conception fails or when they opt for ART in order to carry out preimplantation genetic testing.
KW - ART
KW - BRCA
KW - breast cancer
KW - fertility
KW - pregnancy
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85118855101&partnerID=8YFLogxK
U2 - 10.1016/j.esmoop.2021.100300
DO - 10.1016/j.esmoop.2021.100300
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C2 - 34775302
AN - SCOPUS:85118855101
SN - 2059-7029
VL - 6
JO - ESMO Open
JF - ESMO Open
IS - 6
M1 - 100300
ER -
