BRCA Carriers Conceive After Pregnancy-Related Breast Cancer

TOPLINE:

In a study of BRCA carriers diagnosed with breast cancer during pregnancy, 36.6% successfully had subsequent pregnancies, with no concerning signals seen for maternal prognosis. Patients who conceived were typically younger at diagnosis and more likely to have triple-negative tumours.

METHODOLOGY:

• Researchers conducted a retrospective cohort study including 282 BRCA carriers diagnosed with breast cancer during pregnancy (median age at diagnosis, 33 years) between January 2000 and December 2020.
• Primary endpoints were the cumulative incidence of a subsequent pregnancy and disease-free survival; secondary endpoints were overall survival, patterns of disease-free survival events, and reproductive outcomes.
• Overall, 68 patients had subsequent pregnancies, whereas 214 did not have. The median follow-up duration for the overall cohort was 7.3 years.

TAKEAWAY:

• The 10-year cumulative incidence of a subsequent pregnancy was 36.6% (95% CI, 29.5%-44.8%), and the median time from diagnosis to conception was 3.3 years.
• Among patients achieving pregnancy, 75.9% delivered at term (≥ 37 weeks) and 74.1% experienced no complications, with 79.4% resulting in live births.
• Patients with subsequent pregnancies were younger at diagnosis (median age, 31 vs 34 years) and more often had triple-negative tumours (73.5% vs 55.1%) than those without subsequent pregnancies.
• No significant differences in disease-free survival (adjusted hazard ratio [HR], 1.06; 95% CI, 0.49-2.31; P = .875) and overall survival (HR, 0.63; 95% CI, 0.19-2.05; P = .444) were observed between patients with and without subsequent pregnancies.
• Patients with hormone receptor-positive breast cancer showed a lower 10-year cumulative incidence of pregnancy than those with hormone receptor-negative disease (30.2%; 95% CI, 18.1%-47.8% vs 40.4%; 95% CI, 32.1%-50.0%).

IN PRACTICE:

“Our findings may help in the reproductive counseling of young BRCA carriers wishing to have a subsequent pregnancy after prior diagnosis of PrBC [breast cancer diagnosed during pregnancy],” the authors concluded.

SOURCE:

This study was led by M. Perachino, Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy. It was published online on August 13, 2025, in ESMO Open.

LIMITATIONS:

This was a retrospective study with data collected between 2000 and 2020, potentially affecting current clinical practice relevance. Information on foetal and obstetric outcomes was limited to the first pregnancy after breast cancer treatment, excluding subsequent pregnancies. Contemporary therapies such as pembrolizumab or olaparib were not widely used during the study period, which may have affected the generalisability of the findings to current clinical practice.

DISCLOSURES:

This study received funding support from the Italian Association for Cancer Research. Several authors reported receiving research grants and honoraria and having other ties with various sources. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.