TY - JOUR
T1 - Fertility Preferences and Practices Among Young Women With Breast Cancer
T2 - Germline Genetic Carriers Versus Noncarriers
AU - Lewinsohn, Rebecca
AU - Zheng, Yue
AU - Rosenberg, Shoshana M.
AU - Ruddy, Kathryn J.
AU - Tamimi, Rulla M.
AU - Schapira, Lidia
AU - Peppercorn, Jeffrey
AU - Borges, Virginia F.
AU - Come, Steven
AU - Snow, Craig
AU - Ginsburg, Elizabeth S.
AU - Partridge, Ann H.
N1 - Funding Information:
This work was supported by Susan G. Komen (SAC100008 to A.H.P.) and the Breast Cancer Research Foundation ( BCRF-21-124 to A.H.P.). The funders had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Funding Information:
Dr. Rosenberg reports grant funding from Pfizer, Inc. Dr. Ruddy reports funding from the NIH/NCI, the Department of Defense, and the American Cancer Society; and royalties from UpToDate. Dr. Tamimi reports payment for expert testimony from Sterigenics; and her leadership role as a Koman Scholar. Dr. Schapira reports consulting fees from Novartis and Blue Note Therapeutics. Dr. Peppercorn reports research support from Outcomes4Me, Inc. (paid to institution); consulting fees from Abbott labs; and a family member who is an employee of GlaxoSmithKline. Dr. Borges reports research support (paid to institution) from Seagen, AstraZeneca, Oncosec, and Olema; consulting fees from Seagen and AstraZeneca; and stock ownership in PerlaTx. Dr. Ginsburg reports royalties from UpToDate, Elsevier and Springer/Nature; consulting fees and expert testimony fees from Hall Matson, M Dalton Esq and Associates, and Morrison Maloney; participation on a data safety monitoring board or advisory board for Natpro; and associate editor for Fertility and Sterility. Dr. Partridge reports royalties from UpToDate.
Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/4
Y1 - 2023/4
N2 - Background: Young women with breast cancer who carry germline genetic pathogenic variants may face distinct fertility concerns, yet limited data exist comparing fertility preferences and practices between carriers and noncarriers. Patients and Methods: Participants in the Young Women's Breast Cancer Study (NCT01468246), a prospective cohort of women diagnosed with breast cancer at ≤40 years, who completed a modified Fertility Issues Survey were included in this analysis. Results: Of 1052 eligible participants, 118 (11%) tested positive for a pathogenic variant. Similar proportions (P =. 23) of carriers (46%, [54/118]) and noncarriers (37%, [346/934]) desired more biologic children prediagnosis, and desire decreased similarly postdiagnosis (carriers, 30% [35/118] vs. noncarriers, 26% [244/934], P =. 35). Among those desiring children postdiagnosis (n = 279), concern about cancer risk heritability was more common among carriers (74% [26/35] vs. noncarriers, 36% [88/244], P <. 01). Carriers were more likely to report that concern about cancer risk heritability contributed to a lack of certainty or interest in future pregnancies (20% [16/81] vs. noncarriers, 7% [49/674], P =. 001). Similar proportions (P =. 65) of carriers (36% [43/118]) and noncarriers (38% [351/934]) were somewhat or very concerned about infertility post-treatment; utilization of fertility preservation strategies was also similar (carriers, 14% [17/118] vs. noncarriers, 12% [113/934], P =. 78). Conclusion: Carriers were similarly concerned about future fertility and as likely to pursue fertility preservation as noncarriers. Concern about cancer risk heritability was more frequent among carriers and impacted decisions not to pursue future pregnancies for some, underscoring the importance of counseling regarding strategies to prevent transmission to offspring, including preimplantation genetic testing.
AB - Background: Young women with breast cancer who carry germline genetic pathogenic variants may face distinct fertility concerns, yet limited data exist comparing fertility preferences and practices between carriers and noncarriers. Patients and Methods: Participants in the Young Women's Breast Cancer Study (NCT01468246), a prospective cohort of women diagnosed with breast cancer at ≤40 years, who completed a modified Fertility Issues Survey were included in this analysis. Results: Of 1052 eligible participants, 118 (11%) tested positive for a pathogenic variant. Similar proportions (P =. 23) of carriers (46%, [54/118]) and noncarriers (37%, [346/934]) desired more biologic children prediagnosis, and desire decreased similarly postdiagnosis (carriers, 30% [35/118] vs. noncarriers, 26% [244/934], P =. 35). Among those desiring children postdiagnosis (n = 279), concern about cancer risk heritability was more common among carriers (74% [26/35] vs. noncarriers, 36% [88/244], P <. 01). Carriers were more likely to report that concern about cancer risk heritability contributed to a lack of certainty or interest in future pregnancies (20% [16/81] vs. noncarriers, 7% [49/674], P =. 001). Similar proportions (P =. 65) of carriers (36% [43/118]) and noncarriers (38% [351/934]) were somewhat or very concerned about infertility post-treatment; utilization of fertility preservation strategies was also similar (carriers, 14% [17/118] vs. noncarriers, 12% [113/934], P =. 78). Conclusion: Carriers were similarly concerned about future fertility and as likely to pursue fertility preservation as noncarriers. Concern about cancer risk heritability was more frequent among carriers and impacted decisions not to pursue future pregnancies for some, underscoring the importance of counseling regarding strategies to prevent transmission to offspring, including preimplantation genetic testing.
KW - BRCA1/BRCA2
KW - Breast cancer
KW - Fertility concerns
KW - Pathogenic variants
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UR - http://www.scopus.com/inward/citedby.url?scp=85145981417&partnerID=8YFLogxK
U2 - 10.1016/j.clbc.2022.12.012
DO - 10.1016/j.clbc.2022.12.012
M3 - Article
C2 - 36628811
AN - SCOPUS:85145981417
SN - 1526-8209
VL - 23
SP - 317
EP - 323
JO - Clinical breast cancer
JF - Clinical breast cancer
IS - 3
ER -