11-108284286-A-G
Variant summary
Our verdict is Likely benign. Variant got -1 ACMG points: 0P and 1B. BP4
The NM_000051.4(ATM):βc.3806A>Gβ(p.Lys1269Arg) variant causes a missense change. The variant allele was found at a frequency of 0.0000719 in 1,613,488 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000051.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Likely_benign. Variant got -1 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
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ATM | NM_000051.4 | c.3806A>G | p.Lys1269Arg | missense_variant | Exon 26 of 63 | ENST00000675843.1 | NP_000042.3 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.000118 AC: 18AN: 152206Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000239 AC: 6AN: 251238Hom.: 0 AF XY: 0.0000221 AC XY: 3AN XY: 135806
GnomAD4 exome AF: 0.0000671 AC: 98AN: 1461282Hom.: 0 Cov.: 31 AF XY: 0.0000578 AC XY: 42AN XY: 726966
GnomAD4 genome AF: 0.000118 AC: 18AN: 152206Hom.: 0 Cov.: 32 AF XY: 0.0000807 AC XY: 6AN XY: 74354
ClinVar
Submissions by phenotype
not provided Uncertain:5
Available data are insufficient to determine the clinical significance of the variant at this time. The frequency of this variant in the general population is uninformative in assessment of its pathogenicity. (http://gnomad.broadinstitute.org) Assessment of experimental evidence regarding the effect of this variant on protein function is inconclusive (PMID 31811167). -
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Observed in individuals with personal or family history of breast cancer (Decker et al., 2017; Dominguez-Valentin et al., 2019; Dorling et al., 2021; Bhai et al., 2021); Published functional studies suggest this variant may impact splicing resulting in several aberrant transcripts, but the effect was not complete as some full length transcript was also present in a mini gene assay (Dominguez-Valentin et al., 2019); In silico analysis supports that this missense variant does not alter protein structure/function; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 28779002, 31811167, 33471991, 34326862) -
Ataxia-telangiectasia syndrome Uncertain:3
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This sequence change replaces lysine, which is basic and polar, with arginine, which is basic and polar, at codon 1269 of the ATM protein (p.Lys1269Arg). This variant is present in population databases (rs146017595, gnomAD 0.008%). This missense change has been observed in individual(s) with breast cancer (PMID: 31811167, 34326862). ClinVar contains an entry for this variant (Variation ID: 185981). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is not expected to disrupt ATM protein function with a negative predictive value of 95%. RNA analysis performed to evaluate the impact of this missense change on mRNA splicing indicates it does not significantly alter splicing (internal data). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
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Hereditary cancer-predisposing syndrome Uncertain:2Benign:1
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The p.K1269R variant (also known as c.3806A>G), located in coding exon 25 of the ATM gene, results from an A to G substitution at nucleotide position 3806. The lysine at codon 1269 is replaced by arginine, an amino acid with highly similar properties. This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
not specified Uncertain:1
Variant summary: ATM c.3806A>G (p.Lys1269Arg) results in a conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. Several computational tools predict a significant impact on normal splicing: Two predict the variant strengthens a cryptic 5' donor site. One predict the variant creates a 5' donor site. In a cell-based minigene assay, the variant showed aberrant splicing (Dominguez-Valentin_2019), however the in vivo implication of these studies is not known. The variant allele was found at a frequency of 2.4e-05 in 251238 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.3806A>G has been reported in the literature in individuals affected with breast cancer and prostate cancer (examples: Bhai_2021, Dominguez-Valentin_2019, Mateo_2020). These reports do not provide unequivocal conclusions about association of the variant with Breast Cancer. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 28779002, 34326862, 31811167, 36315919, 31874108). ClinVar contains an entry for this variant (Variation ID: 185981). Based on the evidence outlined above, the variant was classified as uncertain significance. -
Breast and/or ovarian cancer Uncertain:1
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Ataxia-telangiectasia syndrome;C0346153:Familial cancer of breast Uncertain:1
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ATM-related disorder Uncertain:1
The ATM c.3806A>G variant is predicted to result in the amino acid substitution p.Lys1269Arg. This variant has been reported in an individual with breast cancer who has a family history of breast, ovarian, and colorectal cancer (Dominguez-Valentin et al. 2019. PubMed ID: 31811167). In this same study, this variant was shown to lead to aberrant splicing leading to an in-frame deletion using an in vitro minigene assay. No RNA from the patient was available to test splicing effects as an in vivo experiment. ATM levels in the patientβs tumor were weak-to-absent. This variant has also been reported in additional individuals with personal and/or family histories of breast cancer (Table S5, Decker et al. 2017. PubMed ID: 28779002; Table S4, Bhai et al. 2021. PubMed ID: 34326862). This variant was reported in 10 cases in one large study of individuals with breast cancer; however, it was also reported in 3 controls in that study (Dorling et al. 2021. PubMed ID: 33471991). This variant is reported in 0.012% of alleles in individuals of African descent in gnomAD and has conflicting interpretations regarding its pathogenicity in ClinVar, ranging from likely benign to uncertain (https://www.ncbi.nlm.nih.gov/clinvar/variation/185981/). At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -
Familial cancer of breast Uncertain:1
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Hereditary breast ovarian cancer syndrome Uncertain:1
According to the ClinGen ACMG ATM v1.3.0 criteria we chose this criterion: PVS1 (supporting pathogenic): Abberant splicing in minigene Assay PMID: 31811167 -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at