Assisted Reproductive Techniques Are Safe for Breast Cancer Patients with BRCA Mutations

According to a study presented at the 2024 European Society of Medical Oncology Annual Congress on Breast Cancer, maternal and pregnancy outcomes were not negatively affected by the use of assisted reproductive techniques (ART) in breast cancer patients with BRCA mutations. This is the first study to provide evidence that fertility procedures are safe in young women with germline pathogenic/likely pathogenic variants in the BRCA1 or BRCA2 genes.

The Study Details

The study included 5457 patients, of whom only 543 were included for this analysis, while the remaining patients were excluded due to various factors such as lack of data on follow-up. Of the included patients, 107 received ART, and 436 patients did not receive ART. Hormone receptor status included estrogen receptor (ER) negative or progesterone receptor (PR) negative, ER and/or PR positive, HER2 negative, and HER2 positive. Both groups had mostly received chemotherapy, endocrine therapy, or risk-reducing oophorectomy.

Maternal and Pregnancy Outcomes

The study found that 83.0% of ART patients and 79.8% of non-ART patients had a child delivered. Additionally, 4.7% of ART patients and 3.0% of non-ART patients had ongoing pregnancy, 11.3% of ART patients and 8.8% of non-ART patients had a miscarriage, and 0.9% of ART patients and 8.3% of non-ART patients had an induced abortion. At the time of delivery, 85.5% of ART patients and 91.5% of non-ART patients were full-term, while 14.5% of ART patients and 8.5% of non-ART patients were preterm.

Safety of ART Procedures for Breast Cancer Patients with BRCA Mutations

According to Matteo Lambertini, Associate Professor and Consultant in Medical Oncology at the University of Genova, and IRCCS Policlinico San Martino Hospital, in Genova, Italy, “We have previously been concerned that increasing hormone levels for fertility preservation techniques before starting breast cancer treatment may increase the risk of cancer recurrence in the future. There has been even more concern in women with pathogenic variants in the BRCA genes because of their increased risk of breast cancer and other cancers. Strategies to preserve fertility were often not even discussed with these patients.” However, this study indicates that ART is safe for breast cancer patients with BRCA mutations, and fertility procedures can be safely discussed with these patients before starting breast cancer treatment.

Conclusion

The study provides much-needed evidence that the use of assisted reproductive techniques (ART) does not negatively affect maternal or pregnancy outcomes in young women with germline pathogenic/likely pathogenic variants in the BRCA1 or BRCA2 genes. As a result, breast cancer patients with BRCA mutations can discuss fertility preservation techniques like ART with their healthcare providers before starting treatment, without major concern for cancer recurrence in the future.

Assisted Reproductive Techniques Safe for BRCA-Mutated Breast Cancer