Significant changes will indeed make your forecast not come true. But mostly people are not asking to predict for situations with significant changes.
Incremental changes will just be incorporated in the forecasts over time. The forecast continually adjusts to new information becoming available.
It's interesting to know that after about ten work items completed the number become pretty stable. So it's easy to reset or adjust the forecast in case of a big change in the team.
I was personally surprised to learn how stable the output of a team is if its composition doesn't change. Tools have some impact on productivity but so big that you have to throw away your predictions. No one is complaining anyway if you over deliver a little.