The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation
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.
KeywordsBRCA1 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.
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