Safety of having a subsequent pregnancy after prior diagnosis of breast cancer during pregnancy in young BRCA carriers
Bibliographic record
Abstract
BACKGROUND: For women carrying a germline pathogenic or likely pathogenic variant in the BRCA1/2 genes, having a pregnancy following breast cancer diagnosis and treatment is safe. However, no evidence exists on the safety of having a subsequent pregnancy in BRCA carriers with a prior diagnosis of breast cancer during pregnancy (PrBC). METHODS: The BRCA BCY Collaboration (NCT03673306) is an international, multicenter, retrospective cohort study that included BRCA carriers diagnosed with invasive breast cancer at the age ≤40 years between January 2000 and December 2020. This analysis included only women diagnosed with PrBC comparing patients who had a subsequent pregnancy to those without. Primary endpoints were the cumulative incidence of having a subsequent pregnancy and disease-free survival (DFS). Secondary endpoints were overall survival, pattern of first DFS events and reproductive outcomes. RESULTS: Of 6238 BRCA carriers from 109 centers worldwide, 282 patients with PrBC were included in this analysis, of whom 68 had a subsequent pregnancy and 214 did not. The 10-year cumulative incidence of having a subsequent pregnancy was 36.6% [95% confidence interval (CI) 29.5% to 44.8%]. Patients with a subsequent pregnancy were more likely to be younger at diagnosis (median age 31 years versus 34 years) and to have triple-negative tumors (73.5% versus 55.1%). Among patients with a subsequent pregnancy, median time from diagnosis to conception was 3.3 years (interquartile range 2.0-4.3 years). Most pregnancies were delivered at term (≥37 weeks, 75.9%) and without complications (74.1%). Median follow-up was 7.3 years (interquartile range 4.5-11.9 years). No differences in DFS (adjusted hazard ratio (HR) 1.06, 95% CI 0.49-2.31) nor overall survival (adjusted HR 0.63, 95% CI 0.19-2.05) were observed between patients with or without a subsequent pregnancy. CONCLUSIONS: In this global study, one out of three young BRCA carriers diagnosed with PrBC had a subsequent pregnancy. No concerning signals in terms of maternal prognosis or reproductive outcomes were observed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".