Pregnancy After Breast Cancer in Young <i>BRCA </i>Carriers

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Citações na Scopus
6
Tipo de produção
article
Data de publicação
2024
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
AMER MEDICAL ASSOC
Autores
LAMBERTINI, Matteo
BLONDEAUX, Eva
AGOSTINETTO, Elisa
HAMY, Anne-Sophie
KIM, Hee Jeong
MEGLIO, Antonio Di
MOLHO, Rinat Bernstein
HILBERS, Florentine
POGODA, Katarzyna
CARRASCO, Estela
Citação
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, v.331, n.1, p.49-59, 2024
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Importance Young women with breast cancer who have germline pathogenic variants in BRCA1 or BRCA2 face unique challenges regarding fertility. Previous studies demonstrating the feasibility and safety of pregnancy in breast cancer survivors included limited data regarding BRCA carriers.Objective To investigate cumulative incidence of pregnancy and disease-free survival in young women who are BRCA carriers.Design, Setting, and Participants International, multicenter, hospital-based, retrospective cohort study conducted at 78 participating centers worldwide. The study included female participants diagnosed with invasive breast cancer at age 40 years or younger between January 2000 and December 2020 carrying germline pathogenic variants in BRCA1 and/or BRCA2. Last delivery was October 7, 2022; last follow-up was February 20, 2023.Exposure Pregnancy after breast cancer.Main Outcomes and Measures Primary end points were cumulative incidence of pregnancy after breast cancer and disease-free survival. Secondary end points were breast cancer-specific survival, overall survival, pregnancy, and fetal and obstetric outcomes.Results Of 4732 BRCA carriers included, 659 had at least 1 pregnancy after breast cancer and 4073 did not. Median age at diagnosis in the overall cohort was 35 years (IQR, 31-38 years). Cumulative incidence of pregnancy at 10 years was 22% (95% CI, 21%-24%), with a median time from breast cancer diagnosis to conception of 3.5 years (IQR, 2.2-5.3 years). Among the 659 patients who had a pregnancy, 45 (6.9%) and 63 (9.7%) had an induced abortion or a miscarriage, respectively. Of the 517 patients (79.7%) with a completed pregnancy, 406 (91.0%) delivered at term (>= 37 weeks) and 54 (10.4%) had twins. Among the 470 infants born with known information on pregnancy complications, 4 (0.9%) had documented congenital anomalies. Median follow-up was 7.8 years (IQR, 4.5-12.6 years). No significant difference in disease-free survival was observed between patients with or without a pregnancy after breast cancer (adjusted hazard ratio, 0.99; 95% CI, 0.81-1.20). Patients who had a pregnancy had significantly better breast cancer-specific survival and overall survival.Conclusions and RelevanceIn this global study, 1 in 5 young BRCA carriers conceived within 10 years after breast cancer diagnosis. Pregnancy following breast cancer in BRCA carriers was not associated with decreased disease-free survival.
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URI
https://observatorio.fm.usp.br/handle/OPI/58135
Referências
  1. Arecco L, 2023, ESMO OPEN, V8, DOI 10.1016/j.esmoop.2023.102031
  2. Buonomo B, 2021, BMC MED, V19, DOI 10.1186/s12916-021-02081-7
  3. Buonomo B, 2020, BREAST CARE, V15, P148, DOI 10.1159/000501473
  4. Copson ER, 2018, LANCET ONCOL, V19, P169, DOI 10.1016/S1470-2045(17)30891-4
  5. Cui Wanda, 2023, Lancet Oncol, V24, pe415, DOI 10.1016/S1470-2045(23)00390-X
  6. Cullinane CA, 2005, INT J CANCER, V117, P988, DOI 10.1002/ijc.21273
  7. Fine E, 2022, JCO ONCOL PRACT, V18, P165, DOI 10.1200/OP.21.00389
  8. Friebel TM, 2014, JNCI-J NATL CANCER I, V106, DOI 10.1093/jnci/dju091
  9. Goetzinger KR, 2017, AM J PERINAT, V34, P217, DOI 10.1055/s-0036-1585410
  10. Hartnett KP, 2018, CANCER-AM CANCER SOC, V124, P4401, DOI 10.1002/cncr.31732
  11. Lambertini M, 2020, ANN ONCOL, V31, P1664, DOI 10.1016/j.annonc.2020.09.006
  12. Lambertini M, 2021, J CLIN ONCOL, V39, P3293, DOI 10.1200/JCO.21.00535
  13. Lambertini M, 2020, J CLIN ONCOL, V38, DOI 10.1200/JCO.19.02399
  14. Magnus MC, 2019, BMJ-BRIT MED J, V364, DOI 10.1136/bmj.l869
  15. Mangiardi-Veltin M, 2022, REPROD BIOMED ONLINE, V44, P1031, DOI 10.1016/j.rbmo.2021.12.019
  16. Martin Joyce A, 2023, NCHS Data Brief, P1
  17. Ntemou E, 2022, SCI REP-UK, V12, DOI 10.1038/s41598-022-05357-x
  18. Oktay K, 2018, J CLIN ONCOL, V36, P1994, DOI 10.1200/JCO.2018.78.1914
  19. Oktay KH, 2020, FERTIL STERIL, V113, P1251, DOI 10.1016/j.fertnstert.2020.01.033
  20. Paluch-Shimon S, 2022, ANN ONCOL, V33, P1097, DOI 10.1016/j.annonc.2022.07.007
  21. Pan H, 2014, CANCER EPIDEMIOL, V38, P1, DOI 10.1016/j.canep.2013.11.004
  22. Partridge AH, 2023, NEW ENGL J MED, V388, P1645, DOI 10.1056/NEJMoa2212856
  23. Ruddy KJ, 2014, J CLIN ONCOL, V32, P1151, DOI 10.1200/JCO.2013.52.8877
  24. Schemper M, 1996, CONTROL CLIN TRIALS, V17, P343, DOI 10.1016/0197-2456(96)00075-X
  25. Sessa C, 2023, ANN ONCOL, V34, P33, DOI 10.1016/j.annonc.2022.10.004
  26. Shandley LM, 2017, FERTIL STERIL, V107, P243, DOI 10.1016/j.fertnstert.2016.10.020
  27. Tryggvadottir L, 2003, BREAST CANCER RES, V5, pR121, DOI 10.1186/bcr619
  28. Turan V, 2021, J CLIN ONCOL, V39, P2016, DOI 10.1200/JCO.20.02880
  29. von Elm E, 2007, LANCET, V370, P1453, DOI 10.1016/S0140-6736(07)61602-X
  30. Winship AL, 2022, NAT CANCER, V3, DOI 10.1038/s43018-022-00413-x
  31. Winship AL, 2020, HUM REPROD, V35, P1864, DOI 10.1093/humrep/deaa128

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/24
Artigos e Materiais de Revistas Científicas - ODS/03