Pregnancy Safe After Breast Cancer in Young Women With BRCA Mutation
A large, international study found that young women with a BRCA1 or BRCA2 mutation could safely get pregnant after being diagnosed with breast cancer — there were no negative effects on either mother or baby.
The research was presented at the 2023 San Antonio Breast Cancer Symposium and published simultaneously in JAMA. Read “Pregnancy After Breast Cancer in Young BRCA Carriers: An International Hospital-Based Cohort Study.”
Why do the study?
Research suggests that about 12% of younger women diagnosed with breast cancer carry a BRCA1 or BRCA2 mutation. Many of these younger women would like to have a child when they’ve completed treatment. But doctors have been concerned about the safety of pregnancy after a breast cancer diagnosis.
A study published in 2020 suggested pregnancy after breast cancer seemed safe for women with a BRCA mutation, but the study only included 1,252 women. So the researchers weren’t sure if the results could be widely applied.
The 2022 POSITIVE trial found that women with a history of hormone receptor-positive breast cancer could safely pause hormonal therapy to have a child. But few of the 516 women in that study had a BRCA mutation.
There was still a need for more research focused on BRCA carriers. So researchers who did the 2020 study invited more women to participate to help provide clearer guidance for women and their doctors.
About the study
The study included the original 1,252 women, plus another 3,480 women, for a total of 4,732 women with a BRCA mutation.
The women were all age 40 or younger when diagnosed with breast cancer, and all were diagnosed between January 2000 and December 2020.
The women were followed for between 4.5 and 12.6 years.
During the study 659 women had at least one pregnancy after breast cancer. The last baby delivery happened on Oct. 7, 2022.
This means that about 20%, or one in five women, became pregnant after breast cancer.
Compared with women who didn’t get pregnant, women who became pregnant were:
younger when diagnosed
more likely to have a BRCA1 mutation
more likely to have ovarian shutdown, if diagnosed with hormone receptor-positive breast cancer
During follow-up, 2,443 women had their ovaries and fallopian tubes removed preventively to reduce their risk of recurrence (the breast cancer coming back) or developing ovarian cancer:
279 of the women who became pregnant had this surgery
2,164 of women who didn’t become pregnant had this surgery
All the bulleted factors above could influence cancer recurrence rates.
But there was no difference in disease-free survival rates between women who became pregnant and women who did not.
Disease-free survival is how long someone lives without a breast cancer recurrence.
The researchers noted that becoming pregnant was linked to a lower risk of dying from breast cancer and also a lower risk of dying from any cause.
Only 13.5% of the women or babies had complications, and most did not seem to be related to breast cancer treatment:
6.3% of women had a pregnancy complication
5.3% of women had a delivery complication
three of the babies had a congenital abnormality (two had malformed hearts, and one had a chromosomal abnormality)
three of the babies had fetal complications (two had breathing problems, and one had jaundice that was treated with light therapy)
“These results provide reassuring evidence for the oncofertility counseling of young BRCA carriers interested in conceiving following diagnosis and treatment for breast cancer,” said Matteo Lambertini, MD, PhD, of the University of Genova in Italy, who presented the results. “Conceiving after proper treatment and follow-up for breast cancer should not be contraindicated anymore in young BRCA carriers.”
What this means for you
If you’re a young woman with a BRCA mutation who’s been diagnosed with breast cancer and want to have a child after breast cancer treatment, this study offers very encouraging results. Combined with the latest analysis of data from the POSITIVE trial — suggesting that fertility preservation and assisted reproductive technologies don’t increase the risk of recurrence — these results should ease many concerns about having children after breast cancer.
Listen to the episode of The Breastcancer.org Podcast featuring Dr. Hatem Azim discussing his latest analysis of POSITIVE trial data.
ART Doesn’t Increase Hormone Receptor-Positive Breast Cancer Recurrence Risk
Dec 7, 2023If having a child after breast cancer is important to you, it makes sense to talk to your doctor about this study and all your options for fertility preservation and reproductive technologies before you start treatment. This will allow you to take advantage of any and all options that might be right for you.
— Last updated on August 7, 2025 at 2:56 PM