Breast Cancer Research and Treatment

, Volume 142, Issue 1, pp 177–185 | Cite as

The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation

  • Adriana Valentini
  • Jan Lubinski
  • Tomasz Byrski
  • Parviz Ghadirian
  • Pal Moller
  • Henry T. Lynch
  • Peter Ainsworth
  • Susan L. Neuhausen
  • Jeffrey Weitzel
  • Christian F. Singer
  • Olufunmilayo I. Olopade
  • Howard Saal
  • Dominique Stoppa Lyonnet
  • William D. Foulkes
  • Charmaine Kim-Sing
  • Siranoush Manoukian
  • Dana Zakalik
  • Susan Armel
  • Leigha Senter
  • Charis Eng
  • Eva Grunfeld
  • Anna M. Chiarelli
  • Aletta Poll
  • Ping Sun
  • Steven A. NarodEmail author
  • The Hereditary Breast Cancer Clinical Study Group


Physicians are often approached by young women with a BRCA mutation and a recent history of breast cancer who wish to have a baby. They wish to know if pregnancy impacts upon their future risks of cancer recurrence and survival. To date, there is little information on the survival experience of women who carry a mutation in one of the BRCA genes and who become pregnant. From an international multi-center cohort study of 12,084 women with a BRCA1 or BRCA2 mutation, we identified 128 case subjects who were diagnosed with breast cancer while pregnant or who became pregnant after a diagnosis of breast cancer. These women were age-matched to 269 mutation carriers with breast cancer who did not become pregnant (controls). Subjects were followed from the date of breast cancer diagnosis until the date of last follow-up or death from breast cancer. The Kaplan–Meier method was used to estimate 15-year survival rates. The hazard ratio for survival associated with pregnancy was calculated using a left-truncated Cox proportional hazard model, adjusting for other prognostic factors. Among women who were diagnosed with breast cancer when pregnant or who became pregnant thereafter, the 15-year survival rate was 91.5 %, compared to a survival of 88.6 % for women who did not become pregnant (adjusted hazard ratio = 0.76; 95 % CI 0.31–1.91; p = 0.56). Pregnancy concurrent with or after a diagnosis of breast cancer does not appear to adversely affect survival among BRCA1/2 mutation carriers.


BRCA1 BRCA2 Breast cancer Pregnancy Survival 



The authors would like to acknowledge the study coordinators, Roxana Bucur Marcia Llacuachaqui, Alejandra Ragone, Jennifer Ng, Sara Elmi and Linda Steele. Supported by the Canadian Breast Cancer Foundation and the Women’s College Hospital. Also supported by NIH RO1CA74415 (S.L.N.) and P30 CA033752. S.L.N. is the Morris and Horowitz Families Endowed Professor. Recruitment of cases from the City of Hope Clinical Cancer Genetics Community Research Network is supported by Award Number RC4A153828 (PI: J.W.) from the National Cancer Institute and the Office of the Director, National Institutes of Health. The study conducted complies with the current laws of the country in which they were performed.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10549_2013_2729_MOESM1_ESM.doc (26 kb)
Fig 4 (supplemental) Breast cancer-specific survival for subjects with and without a pregnancy: from ascertainment (DOC 25 kb)
10549_2013_2729_MOESM2_ESM.doc (26 kb)
Fig 5 (supplemental) Recurrence-free survival in subjects with and without a pregnancy after breast cancer: Follow-up from date of last birth (DOC 25 kb)


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Adriana Valentini
    • 1
  • Jan Lubinski
    • 2
  • Tomasz Byrski
    • 2
  • Parviz Ghadirian
    • 3
  • Pal Moller
    • 4
  • Henry T. Lynch
    • 5
  • Peter Ainsworth
    • 6
  • Susan L. Neuhausen
    • 7
  • Jeffrey Weitzel
    • 8
  • Christian F. Singer
    • 9
  • Olufunmilayo I. Olopade
    • 10
  • Howard Saal
    • 11
  • Dominique Stoppa Lyonnet
    • 12
  • William D. Foulkes
    • 13
  • Charmaine Kim-Sing
    • 14
  • Siranoush Manoukian
    • 15
  • Dana Zakalik
    • 16
  • Susan Armel
    • 17
  • Leigha Senter
    • 18
  • Charis Eng
    • 19
    • 20
  • Eva Grunfeld
    • 21
  • Anna M. Chiarelli
    • 22
    • 23
  • Aletta Poll
    • 1
  • Ping Sun
    • 1
  • Steven A. Narod
    • 1
    • 22
    • 24
    Email author
  • The Hereditary Breast Cancer Clinical Study Group
  1. 1.Women’s College Research InstituteTorontoCanada
  2. 2.Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
  3. 3.Epidemiology Research Unit, Research Center of the University of Montreal Hospital Centre (CRCHUM)MontrealCanada
  4. 4.Research Group on Inherited Cancer, Department of Medical GeneticsOslo University HospitalRadiumhosptialetNorway
  5. 5.Department of Preventive Medicine and Public HealthCreighton University School of MedicineOmahaUSA
  6. 6.London Regional Cancer ProgramLondonCanada
  7. 7.Department of Population SciencesBeckman Research Institute of City of HopeDuarteUSA
  8. 8.City of Hope National Medical CenterDuarteUSA
  9. 9.Department of Obstetrics and Gynaecology and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
  10. 10.Center for Clinical Cancer GeneticsUniversity of ChicagoChicagoUSA
  11. 11.Hereditary Cancer Program, Division of Human GeneticsChildren’s Hospital Medical CenterCincinnatiUSA
  12. 12.Service de Génétique OncologiqueInstitut Curie Hôpital, Institut Curie Centre de RechercheParisFrance
  13. 13.Department of Medical GeneticsMcGill UniversityMontrealCanada
  14. 14.BC Cancer AgencyVancouverCanada
  15. 15.Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  16. 16.Cancer Genetics ProgramBeaumont HospitalRoyal OakUSA
  17. 17.Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Princess Margaret HospitalUniversity of TorontoTorontoCanada
  18. 18.Division of Human GeneticsThe Ohio State University Medical CenterColumbusUSA
  19. 19.Genomic Medicine Institute and Center for Personalized Genetic HealthcareCleveland ClinicClevelandUSA
  20. 20.Department of Genetics and Genome Sciences and Comprehensive Cancer CenterCase Western Reserve UniversityClevelandUSA
  21. 21.Department of Family and Community MedicineUniversity of TorontoTorontoUSA
  22. 22.Dalla Lana School of Public HealthUniversity of TorontoTorontoUSA
  23. 23.Cancer Care OntarioTorontoUSA
  24. 24.Women’s College Research InstituteTorontoCanada

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