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

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...

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Detalles Bibliográficos
Autores: Condorelli, M, Bruzzone, M, Ceppi, M, Ferrari, A, Grinshpun, A, Hamy, A S, de Azambuja, E, Carrasco, E, Peccatori, F A, Di Meglio, A, Paluch-Shimon, S, Poorvu, P D, Venturelli, M, Rousset-Jablonski, C, Senechal, C, Livraghi, L, Ponzone, R, De Marchis, L, Pogoda, K, Sonnenblick, A, Villarreal-Garza, C, Cordoba, O, Teixeira, L, Clatot, F, Punie, K, Graffeo, R, Dieci, M V, Perez-Fidalgo, J A, Duhoux, F P, Puglisi, F, Ferreira, A R, Blondeaux, E, Peretz-Yablonski, T, Caron, O, Saule, C, Ameye, L, Balmana, J, Partridge, A H, Azim, H A, Demeestere, I, Lambertini, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p16331
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/16331
Access Level:acceso abierto
Palabra clave:ART
BRCA
breast cancer
fertility
pregnancy
survival
Descripción
Sumario: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.

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