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Supportive and palliative care

4492 - Reproductive potential and performance of fertility-preserving procedures in BRCA mutation-positive (BRCA+) breast cancer (BC) patients (pts)


09 Sep 2017


Supportive and palliative care


Matteo Lambertini


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


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


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Abstract 4492


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.


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.


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.


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




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.

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