Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Reproductive potential and performance of fertility-preserving procedures in BRCA mutation-positive (BRCA+) breast cancer (BC) patients (pts)

Date

09 Sep 2017

Session

Supportive and palliative care

Presenters

Matteo Lambertini

Citation

Annals of Oncology (2017) 28 (suppl_5): v605-v649. 10.1093/annonc/mdx440

Authors

M. Lambertini1, O. Goldrat2, A.R. Ferreira3, J. Dechene2, J. Desir4, A. Delbaere2, M. t’Kint de Roodenbeke5, E. De Azambuja5, M. Ignatiadis5, I. Demeestere2

Author affiliations

  • 1 Breast Cancer Translational Research Laboratory, Institute Jules Bordet, 1000 - Brussels/BE
  • 2 Fertility Clinic, CUB-Hôpital Erasme, Brussels/BE
  • 3 Medical Oncology, Centro Hospitalar Lisboa Norte - Hospital Sta Maria (HSM-CHLN), 1649-035 - Lisbon/PT
  • 4 Medical Genetics Department, CUB-Hôpital Erasme, Brussels/BE
  • 5 Department Of Medicine, Institute Jules Bordet, 1000 - Brussels/BE
More

Resources

Background

Preclinical evidence suggests a possible negative impact of germline BRCA mutations on female fertility. However, the reproductive potential and performance of fertility-preserving procedures in BRCA+ BC pts remain largely uncertain. We aimed to assess fertility outcomes in BRCA+ BC pts who underwent oocyte cryopreservation (OC) or ovarian tissue cryopreservation (OTC) before (neo)adjuvant chemotherapy.

Methods

This was a retrospective analysis of two prospective single center studies investigating OC and OTC in early BC pts. The present analysis included known BRCA+ or BRCA mutation-negative (BRCA-) BC pts who underwent OC or OTC between January 2006 and December 2016. Pts with unknown BRCA status, BRCA variants of unknown significance or other germline mutations were excluded. Baseline anti-mullerian hormone (AMH), OC and OTC performance were compared between BRCA+ and BRCA- BC pts.

Results

Out of 98 pts included in this analysis, 29 were BRCA+ and 69 BRCA-. Median age was 31 (range: 29-33) and 30 (range: 28-33) years in BRCA+ and BRCA- BC pts, respectively. Baseline AMH was 1.8 ng/ml (range: 1-2.7) in BRCA+ and 2.6 ng/ml (range: 1.4-4.3) in BRCA- BC pts (p = 0.108). Among pts who underwent OC (n = 27), despite receiving a numerically higher dose of gonadotropins (2775 vs 2150 UI; p = 0.125) and longer duration of stimulation (11.5 vs 9; p = 0.164), BRCA+ pts tended to retrieve (6.5 vs. 10; p = 0.135) and to cryopreserve (3.5 vs 6; p = 0.134) less oocytes than BRCA- pts. Poor response rate (i.e. retrieval of ≤ 4 oocytes) was 40% in BRCA+ and 12.5% in BRCA- BC pts (p = 0.105). Among pts who underwent OTC (n = 71), BRCA+ pts had numerically lower oocyte density per fragment (0.08 vs 0.14; p = 0.224) and per mm2 (0.33 vs 0.75; p = 0.160) than BRCA- pts. Two BRCA+ pts were transplanted after chemotherapy and one delivered at term a healthy baby. No difference between BRCA1+ and BRCA2+ pts was observed in any of the above-mentioned outcomes.

Conclusions

This is the largest study addressing fertility issues in BRCA+ BC pts. We observed a trend for reduced reproductive potential and performance of OC and OTC in BRCA+ BC pts. Further research efforts in this field are urgently needed.

Clinical trial identification

Not applicable

Legal entity responsible for the study

CUB-Hôpital Erasme

Funding

None

Disclosure

E. De Azambuja, M. Ignatiadis: Honoraria from Roche and travel grants from Roche and GlaxoSmithKline outside the submitted work. All other authors have declared no conflicts of interest.

Resources from the same session

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings