It is possible and safe to become a mother after being diagnosed with breast cancer caused by BRCA gene mutations. This is according to a study recently published in the prestigious medical journal JAMA and presented at the recent San Antonio Breast Cancer Symposium, the most important international breast cancer congress. The results show that women with BRCA gene mutations who have had breast cancer can safely become pregnant. The study, coordinated by Matteo Lambertini of the University of Genoa, involved several centres around the world, including the IRCCS San Gerardo dei Tintori Foundation in Monza.
Mutations in the BRCA1 and BRCA2 genes (where BR stands for breast and CA for cancer) are risk factors for breast and ovarian cancer: that is, those who carry them are more likely to develop breast and ovarian cancer. The case of actress Angelina Jolie, who had a preventive mastectomy because she carried these mutations, is well known. The new study analysed data from 4,732 women - average age 35 - who were followed at 78 centres around the world. One in five became pregnant within 10 years of their cancer diagnosis, with the average time from diagnosis to pregnancy being 3.5 years. Not only was pregnancy shown to be feasible and safe (rates of complications or risk of fetal malformations were similar to those in the general population), but there was no increased likelihood of tumour recurrence in these patients.
Pregnancy after breast cancer is generally considered safe, but data on BRCA carriers are limited. Concerns about the maternal and foetal safety of pregnancy after breast cancer have mainly been based on an alleged link between increased hormones in pregnancy and the risk of tumour recurrence. "Instead, the results of this study allow us to dispel the myth that pregnancy hormones can have a negative impact on the oncological outcome of these young women," comments Robert Fruscio, Professor of Gynaecology and Obstetrics at the University of Milano-Bicocca and principal investigator of the Monza centre. "We can finally provide reassurance that, after adequate treatment of breast cancer and an appropriate observation period, pregnancy should no longer be discouraged in these women." "We are very pleased to have made a significant contribution to this study, which allows a decisive step forward in the treatment of women with BRCA gene mutations, and we are proud to have become, over the years, a reference centre for the prevention of gynaecological cancers in women with increased genetic risk," adds Fabio Landoni, Director of the Gynaecology Clinic at the IRCCS San Gerardo dei Tintori Foundation and Professor of Gynaecology and Obstetrics at the University of Milan-Bicocca. "The work just published is an excellent example of how rigorously conducted research can have an immediate and practical impact in the clinic."