title: The impact of pregnancy on breast cancer survival in women who carry a BRCA1 or BRCA2 mutation.
abstract: Physicians are often approached by young women with a BRCA mutation and a recent history of breast cancer who wish to have a baby. They wish to know if pregnancy impacts upon their future risks of cancer recurrence and survival. To date, there is little information on the survival experience of women who carry a mutation in one of the BRCA genes and who become pregnant. From an international multi-center cohort study of 12,084 women with a BRCA1 or BRCA2 mutation, we identified 128 case subjects who were diagnosed with breast cancer while pregnant or who became pregnant after a diagnosis of breast cancer. These women were age-matched to 269 mutation carriers with breast cancer who did not become pregnant (controls). Subjects were followed from the date of breast cancer diagnosis until the date of last follow-up or death from breast cancer. The Kaplan-Meier method was used to estimate 15-year survival rates. The hazard ratio for survival associated with pregnancy was calculated using a left-truncated Cox proportional hazard model, adjusting for other prognostic factors. Among women who were diagnosed with breast cancer when pregnant or who became pregnant thereafter, the 15-year survival rate was 91.5 %, compared to a survival of 88.6 % for women who did not become pregnant (adjusted hazard ratio = 0.76; 95 % CI 0.31-1.91; p = 0.56). Pregnancy concurrent with or after a diagnosis of breast cancer does not appear to adversely affect survival among BRCA1/2 mutation carriers.
authors.affiliation: Women's College Research Institute, Toronto, ON, Canada.
authors.forename: Adriana
authors.initials: A
authors.lastname: Valentini
authors.forename: Jan
authors.initials: J
authors.lastname: Lubinski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Byrski
authors.forename: Parviz
authors.initials: P
authors.lastname: Ghadirian
authors.forename: Pal
authors.initials: P
authors.lastname: Moller
authors.forename: Henry T
authors.initials: HT
authors.lastname: Lynch
authors.forename: Peter
authors.initials: P
authors.lastname: Ainsworth
authors.forename: Susan L
authors.initials: SL
authors.lastname: Neuhausen
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Weitzel
authors.forename: Christian F
authors.initials: CF
authors.lastname: Singer
authors.forename: Olufunmilayo I
authors.initials: OI
authors.lastname: Olopade
authors.forename: Howard
authors.initials: H
authors.lastname: Saal
authors.forename: Dominique Stoppa
authors.initials: DS
authors.lastname: Lyonnet
authors.forename: William D
authors.initials: WD
authors.lastname: Foulkes
authors.forename: Charmaine
authors.initials: C
authors.lastname: Kim-Sing
authors.forename: Siranoush
authors.initials: S
authors.lastname: Manoukian
authors.forename: Dana
authors.initials: D
authors.lastname: Zakalik
authors.forename: Susan
authors.initials: S
authors.lastname: Armel
authors.forename: Leigha
authors.initials: L
authors.lastname: Senter
authors.forename: Charis
authors.initials: C
authors.lastname: Eng
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
authors.forename: Anna M
authors.initials: AM
authors.lastname: Chiarelli
authors.forename: Aletta
authors.initials: A
authors.lastname: Poll
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.forename: Steven A
authors.initials: SA
authors.lastname: Narod
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006579:Heterozygote; D006801:Humans; D009154:Mutation; D011247:Pregnancy; D012307:Risk Factors