by Health Editorial Staff
No increased risk for women who have had breast cancer and want to become pregnant. Not even for those who carry the BRCA 1 and 2 gene mutation
The green light to have a child after breast cancer, even in younger patients with hereditary breast cancer related to the presence of mutations in the BRCA gene: 12% of the over 11,000 young women of childbearing age who develop breast cancer every year in Italy breast. In these women with the “Jolie mutation”, the same one that led Angelina Jolie to undergo a preventive mastectomy and which predisposes to the development of breast and ovarian tumors, pregnancy at the end of oncological treatment was until now not recommended, on the one hand because it was feared it would entail a greater risk of the tumor returning, on the other hand because possible dangers for the child were hypothesized due to exposure to previous oncological therapies including chemotherapy.
Data collected over 10 years
Unfounded fears, as demonstrated by the largest international study conducted to verify the outcomes of pregnancies in young women with breast cancer and BRCA mutations, coordinated by the IRCCS Policlinico San Martino Hospital in Genoa and carried out with the support of AIRC. The data, published in the prestigious journal JAMA and presented simultaneously during the San Antonio Breast Cancer Symposium, the most important world congress on breast cancer, demonstrate that 10 years after diagnosis one in five patients had a pregnancy without any registered more frequent complications during the wait or greater dangers for unborn babies, nor an increase in the probability of the tumor returning.
Pregnancy should no longer be discouraged
«These data demonstrate that, after appropriate treatment and a sufficient observation period, pregnancy should no longer be discouraged for young women with breast cancer and a BRCA mutation, because it is possible and safe. Being able to cultivate the hope of building a family in the future, after cancer, is of great help to patients because it allows them to better accept the disease and the therapies: the awareness of a possible tomorrow has a significant role in the healing process”, observes Matteo Lambertini, Associate Professor and Medical Oncologist at the Medical Oncology Clinic of the University of Genoa – IRCCS Policlinico San Martino Hospital in Genoa, coordinator of the research together with Eva Blondeaux, Medical Oncologist at the Clinical Epidemiology Unit of the IRCCS Hospital San Martino Polyclinic in Genoa.
The number of cases of young women affected by breast cancer before having had a child is increasing, also thanks to the tendency to seek the first pregnancy at an increasingly advanced age; furthermore, cancer treatments can lead to a reduction in fertility and the ability to conceive. Motherhood therefore represents a topic of crucial importance for the over 11,000 young women of childbearing age who develop breast cancer every year in Italy, of which over 12% are carriers of the BRCA gene mutation.
The study is a retrospective international investigation in which 78 centers around the world participated, including major cancer centers and universities. For the research, data was collected from 4732 women who received a diagnosis of breast cancer with BRCA mutation within the age of 40; after completing treatment and within 10 years of cancer diagnosis, one in five (22%) had a pregnancy, with an average time from diagnosis to conception of 3 and a half years. Of the 517 women who completed their pregnancies, equal to 79.7% of the total, 91% had a full-term birth and 10% had twins. No higher than expected rates of pregnancy complications or risk of fetal malformations were observed in the general population, nor significant differences in disease-free survival between patients who did or did not become pregnant at the end of oncological treatment: having a child does not therefore increase the probability of subsequent tumor recurrence.
«Don’t steal the future»
«In the past, pregnancy was not recommended for these women – explains Matteo Lambertini – due to the concern on the one hand that the “pregnancy hormones” could favor the reappearance of breast cancer, being a tumor sensitive to hormones, and on the other that a previous exposure to oncological treatments, including chemotherapy, could have negative consequences on the offspring. Furthermore, to avoid the development of ovarian cancer, these patients are candidates to receive preventive surgery to remove the ovaries and tubes at a very young age, around the age of 40, and this therefore further reduces their reproductive window. Added to this is the fear of transmitting the mutation to their children, which influences the desire for motherhood in many of these women. All these elements ‘steal the future’ from young patients with hereditary breast cancer, but the new data mark a decisive change of pace – underlines Lambertini – Pregnancy should no longer be discouraged in women carriers of the “Jolie mutation” who wish to have a child after undergoing adequate treatment for breast cancer and after an appropriate observation period has elapsed since the end of therapy: indeed, the data show that overall survival can even improve in some cases, in women who realize their wish family” concludes Lambertini.
Corriere della Sera is also on Whatsapp. It’s enough click here to subscribe to the channel and always be updated.
December 7, 2023 (modified December 7, 2023 | 6:31 pm)
© ALL RIGHTS RESERVED