Assisted reproductive technology in young BRCA carriers with a pregnancy after breast cancer: An international cohort study.
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Magaton Isotta Martha, Blondeaux Eva, Hamy Anne-Sophie, Linn Sabine, Bernstein-Molho Rinat, Peccatori Fedro A, Ferrari Alberta, Carrasco Estela, Paluch-Shimon Shani, Agostinetto Elisa, Venturelli Marta, Luis Ines Maria Vaz, Rodriguez-Wallberg Kenny A, Kim Hee Jeong, Sorouri Kimia, Renaud Tiphaine, Moore Halle C F, Cui Wanda, Bajpa Jyoti, Rousset-Jablonski Christine, De Marchis Laura, Yerushalmi Rinat, Wong Stephanie M, Han Sileny, Phillips Kelly-Anne, Pogoda Katarzyna, Puglisi Fabio, Chirco Alessandra, Duhoux Francois P, Meattini Icro, Villarreal-Garza Cynthia, Vernieri Claudio, Bruzzone Marco, Demeestere Isabelle, Azim Hatem A, Partridge Ann H, Lambertini Matteo
Аннотация
METHODS: This is an international, hospital-based, retrospective cohort study including BRCA1/2 carriers with a pregnancy after prior breast cancer diagnosis at ≤ 40 years of age between 2000 and 2020. Outcomes were compared between young BRCA1/2 carriers who conceived using ART and those who conceived spontaneously.
RESULTS: Among 543 BRCA1/2 carriers with a pregnancy after breast cancer, 436 conceived spontaneously and 107 using ART. Of 107 pregnancies achieved with ART, 45 (42.1 %) were obtained using oocytes/embryo cryopreserved at diagnosis, 33 (30.8 %) after controlled ovarian stimulation for in-vitro-fertilization/intracytoplasmic sperm injection or ovulation induction for intrauterine insemination or planned intercourse after anticancer treatments, 21 (19.6 %) after oocyte donation, while for 8 (7.5 %) patients type of ART was missing. Compared to patients in the no-ART group, those in the ART group were older at the time of conception, had more frequently hormone receptor-positive breast cancer and a longer median time from cancer diagnosis to conception. At a median follow-up of 5.2 years after conception, no apparent detrimental effect of ART on disease-free survival was observed (adjusted HR=0.72, 95 % CI 0.39-1.34).
CONCLUSION: In young BRCA1/2 carriers with a pregnancy after breast cancer, ART use did not appear to be associated with increased risk of DFS events.