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Fertility and Pregnancy Counseling of Breast Cancer Patients with Germline BRCA Mutations

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Fertility Challenges and Solutions in Women with Cancer

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Abstract

Irrespective of their family history, approximately 12% of breast cancer cases diagnosed in women under the age of 40 are hereditary tumors secondary to the presence of germline deleterious mutations in the breast cancer susceptibility genes BRCA1 or BRCA2. The indication to undergo risk-reducing salpingo-oophorectomy at a young age for women carrying a mutation in the BRCA genes has a direct negative impact on patients’ fertility and family planning. In addition, preclinical and limited clinical evidence suggests a possible negative effect of a BRCA mutation on female ovarian reserve and fertility. Based on both the unique features and needs of these patients as well as the limited evidence on the performance of fertility preservation strategies and on the safety of having a pregnancy following the end of anticancer treatments, oncofertility counseling is particularly complex in young women with newly diagnosed BRCA-mutated breast cancer. This chapter aims to review the available evidence on the impact of carrying a germline deleterious BRCA mutation on the reproductive potential of these women as well as to discuss how to optimally manage the oncofertility counseling of young BRCA-mutated breast cancer patients facing fertility and pregnancy-related issues.

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Acknowledgments

Margherita Condorelli acknowledges the support from FNRS-Télévie for the conduction of her PhD at the Research Laboratory on Human Reproduction, CUB-Hôpital Erasme in Brussels (Belgium). Matteo Lambertini acknowledges the support from the European Society for Medical Oncology (ESMO) for a Translational Research Fellowship at the Institut Jules Bordet in Brussels (Belgium) during the writing of this book chapter.

Funding: This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Disclosure: Margherita Condorelli declares no conflicts of interest. Matteo Lambertini served as a consultant for Teva and received speaker honoraria from Theramex and Takeda outside the submitted work.

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Authors and Affiliations

  1. Fertility Clinic, CUB-Hôpital Erasme and Research Laboratory on Human Reproduction, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium

    Margherita Condorelli

  2. Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy

    Matteo Lambertini

  3. Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy

    Matteo Lambertini

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  1. Margherita Condorelli
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Correspondence to Matteo Lambertini .

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Editors and Affiliations

  1. School of Medicine, Tecnologico de Monterrey, Monterrey, Mexico

    Hatem A. Azim Jr

  2. CUB-Erasme, Fertility Clinic, Université Libre de Bruxelles, Brussels, Belgium

    Isabelle Demeestere

  3. Division of Gynecologic Oncology, European Institute of Oncology, Milan, Italy

    Fedro A. Peccatori

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Condorelli, M., Lambertini, M. (2020). Fertility and Pregnancy Counseling of Breast Cancer Patients with Germline BRCA Mutations. In: Azim Jr, H., Demeestere, I., Peccatori, F. (eds) Fertility Challenges and Solutions in Women with Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-24086-8_12

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