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Assisted reproductive technology in young BRCA carriers with a pregnancy after breast cancer: An international cohort study

par Magaton, Isotta Martha;Blondeaux, Eva;Hamy-Petit, Anne Sophie;Linn, Sabine S.C.;Bernstein-Molho, Rinat;Peccatori, Fedro Alessandro;Ferrari, Alberta;Carrasco, Estela;Paluch-Shimon, Shani;Agostinetto, Elisa ;Venturelli, Marta;Vaz-Luis, Ines;Rodriguez-Wallberg, Kenny Alexandra;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 S.M.;Han, Sileny;Phillips, K.A.;Pogoda, Katarzyna;Puglisi, Fabio;Chirco, Alessandra;Duhoux, Francois F.P.;Meattini, Icro;Villarreal-Garza, Cynthia;Vernieri, Claudio;Bruzzone, Marco;Demeestere, Isabelle ;Abdel Azim, Hatem Hamdy ;Partridge, Ann A.H.;Lambertini, Matteo Md Phd M.
Référence European journal of cancer, 222, 115434
Publication Publié, 2025-06-01

Article révisé par les pairs

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Résumé :

Introduction: Very limited data exist on assisted reproductive technology (ART) use in BRCA1/2 carriers conceiving after breast cancer. This study aimed to investigate the safety of ART to achieve a pregnancy after breast cancer in BRCA1/2 carriers. 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.