Risk of Breast and Ovarian Cancer with ICSI

Introduction to Risk Factors

The European Society for Medical Oncology (ESMO) guidelines from 2020 and 2023 do not indicate that ICSI increases the risk of breast or ovarian cancer 1, 2, 3
The primary risk factors for breast and ovarian cancer are genetic and family history, particularly the presence of mutated BRCA1 and BRCA2 genes, which significantly increase the risk 1

For patients who have been treated for cancer, pregnancy should not be prohibited for safety reasons, even in those with hormone receptor-positive breast cancer 4
Pregnancy in cancer survivors should be closely monitored due to potential increased risk of obstetric complications 4

For women with a high risk of breast and ovarian cancer due to BRCA1/2 mutations, risk-reducing salpingo-oophorectomy (RRSO) is an effective method for reducing risk 2, 3, 5
RRSO can reduce the risk of ovarian cancer by 80-90% and decrease all-cause mortality by up to 77% in individuals with BRCA1/2 mutations 3
The use of oral contraceptives may reduce the risk of ovarian cancer by 40-60%, but there is conflicting information about the increased risk of breast cancer in BRCA1/2 mutation carriers 3

For high-risk women, screening with transvaginal ultrasound every 6 months and CA-125 blood tests is recommended, although the benefits are not entirely clear 2, 3
Screening should be performed in experienced institutions with systematic protocols 2, 3

Individuals with a family history of breast or ovarian cancer should consult a doctor to assess their risk and consider genetic testing 6
Those with BRCA1/2 mutations should receive counseling about reproductive options, including preimplantation genetic diagnosis 6, 4
There is no clear evidence that the use of assisted reproductive technology (ART), including ICSI, increases the risk of breast or ovarian cancer in the general population 4