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Journal Article Multicenter Study Research Support, Non-U.S. Gov't Ppublish 15 citations

PubMed: 34775302 DOI: 10.1016/j.esmoop.2021.100300

Safety of assisted reproductive techniques in young women harboring germline pathogenic variants in BRCA1/2 with a pregnancy after prior history of breast cancer.

ESMO Open 6(6):100300

Authors: M Condorelli, M Bruzzone, M Ceppi, A Ferrari, A Grinshpun, A S Hamy, E de Azambuja, E Carrasco, F A Peccatori, A Di Meglio, S Paluch-Shimon, P D Poorvu, M Venturelli, C Rousset-Jablonski, C Senechal, L Livraghi, R Ponzone, L De Marchis, K Pogoda, A Sonnenblick, C Villarreal-Garza, O Córdoba, L Teixeira, F Clatot, K Punie, R Graffeo, M V Dieci, J A Pérez-Fidalgo, F P Duhoux, F Puglisi, A R Ferreira, E Blondeaux, T Peretz-Yablonski, O Caron, C Saule, L Ameye, J Balmaña, A H Partridge, H A Azim, I Demeestere, M Lambertini

Affiliations

  • Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Fertility Clinic, Brussels, Belgium; Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
  • Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Department of Surgical Sciences, General Surgery III-Breast Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical Surgical Sciences, University of Pavia, Pavia, Italy.
  • Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
  • Department of Medical Oncology, Institut Curie, Paris, France.
  • Department of Medicine, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
  • Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
  • Gynecologic Oncology Department, European Institute of Oncology IRCCS, Milan, Italy.
  • Molecular Predictors and New Targets in Oncology, INSERM Unit 981, Gustave Roussy, Villejuif, France.
  • Breast Oncology Unit Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University, Jerusalem, Israel.
  • Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA.
  • Department of Oncology and Haematology, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
  • Department of Surgery, Centre Léon Bérard and INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, Lyon, France.
  • Cancer Genetics Unit, Bergonie Institute, Bordeaux, France.
  • Medical Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy; University of Siena, Siena, Italy.
  • Gynecological Oncology, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, Turin, Italy.
  • Division of Medical Oncology, Department of Radiological, Oncological and Pathological Sciences, "La Sapienza" University of Rome, Rome, Italy.
  • Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
  • Oncology Division, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv, Israel.
  • Breast Cancer Center, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico.
  • Obstetrics and Gynecology Department, Hospital Universitari Son Espases, Palma, Spain.
  • Breast Disease Unit, Saint-Louis Hospital, APHP, Université de Paris, INSERM U976, Paris, France.
  • Department of Medical Oncology, Centre Henri Becquerel, Rouen, France.
  • Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
  • Breast Unit of Southern Switzerland (CSSI), Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
  • Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy; Medical Oncology 2, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
  • Department of Medical Oncology, INCLIVA University Hospital of Valencia, CIBERONC, Valencia, Spain.
  • Department of Medical Oncology, Breast Clinic, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
  • Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Department of Medicine, University of Udine, Udine, Italy.
  • Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal.
  • Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Department of Medical Oncology, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France.
  • Department of Genetics, Institut Curie, Paris, France.
  • Data Centre, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
  • Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova, Italy; Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.

Abstract

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.

MeSH

Cancer Survivors, Pregnancy, Fertility, Safety, Breast Neoplasms, Reproductive Techniques, Assisted, Reproductive Techniques, Neoplasms, Breast, Therapeutics, History, Genes, Brca1

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