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Fertility and Pregnancy Counseling of Breast Cancer Patients with Germline BRCA Mutations.

par Condorelli, Margherita ;Lambertini, Matteo
Editeur scientifique Azim, Hatem A;Demeestere, Isabelle ;Peccatori, Fedro Alessandro
Référence Fertility and Pregnancy Counseling of Breast Cancer Patients with Germline BRCA Mutations., Springer, Cham, Vol. Fertility Challenges and Solutions in Women with Cancer, Ed. 1, Fertility Challenges and Solutions in Women with Cancer
Publication Publié, 2019-10-31

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Résumé :

Irrespective of their family history, approximately 12% of breast cancer cases diagnosed in women under the age of 40 are hereditary tumors secondary to the presence of germline deleterious mutations in the breast cancer susceptibility genes BRCA1 or BRCA2. The indication to undergo risk-reducing salpingo-oophorectomy at a young age for women carrying a mutation in the BRCA genes has a direct negative impact on patients’ fertility and family planning. In addition, preclinical and limited clinical evidence suggests a possible negative effect of a BRCA mutation on female ovarian reserve and fertility. Based on both the unique features and needs of these patients as well as the limited evidence on the performance of fertility preservation strategies and on the safety of having a pregnancy following the end of anticancer treatments, oncofertility counseling is particularly complex in young women with newly diagnosed BRCA-mutated breast cancer. This chapter aims to review the available evidence on the impact of carrying a germline deleterious BRCA mutation on the reproductive potential of these women as well as to discuss how to optimally manage the oncofertility counseling of young BRCA-mutated breast cancer patients facing fertility and pregnancy-related issues.