16-23636035-ATC-A

Variant names:

• chr16-23636035-ATC-A
• rs515726123
• NM_024675.4:c.509_510delGA

Variant summary

Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PVS1 PP5_Very_Strong

The NM_024675.4(PALB2):​c.509_510delGA​(p.Arg170IlefsTer14) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000186 in 1,614,006 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★). Variant results in nonsense mediated mRNA decay.

• Frequency:
  • Genomes: 𝑓 0.000013 (0 hom., cov: 32)
  • Exomes 𝑓: 0.000019 (0 hom.)
• Consequence: PALB2 NM_024675.4 frameshift
• Clinical Significance: Pathogenic criteria provided, multiple submitters, no conflicts P:47
• Conservation: PhyloP100: -0.0180

Genes affected

PALB2 (HGNC:26144): (partner and localizer of BRCA2) This gene encodes a protein that may function in tumor suppression. This protein binds to and colocalizes with the breast cancer 2 early onset protein (BRCA2) in nuclear foci and likely permits the stable intranuclear localization and accumulation of BRCA2. [provided by RefSeq, Jul 2008]

ACMG classification

Verdict is Pathogenic. Variant got 16 ACMG points.

• PVS1: Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
• PP5: Variant 16-23636035-ATC-A is Pathogenic according to our data. Variant chr16-23636035-ATC-A is described in ClinVar as [Pathogenic]. Clinvar id is 126757.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr16-23636035-ATC-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
PALB2	NM_024675.4	c.509_510delGA	p.Arg170IlefsTer14	frameshift_variant	Exon 4 of 13	ENST00000261584.9	NP_078951.2

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
PALB2	ENST00000261584.9	c.509_510delGA	p.Arg170IlefsTer14	frameshift_variant	Exon 4 of 13	1	NM_024675.4	ENSP00000261584.4

Frequencies

GnomAD3 genomes AF: 0.0000131 AC: 2 AN: 152126 Hom.: 0 Cov.: 32

Gnomad AFR AF: 0.00

Gnomad AMI AF: 0.00

Gnomad AMR AF: 0.00

Gnomad ASJ AF: 0.00

Gnomad EAS AF: 0.00

Gnomad SAS AF: 0.00

Gnomad FIN AF: 0.00

Gnomad MID AF: 0.00

Gnomad NFE AF: 0.0000294

Gnomad OTH AF: 0.00

GnomAD3 exomes AF: 0.0000358 AC: 9 AN: 251446 Hom.: 0 AF XY: 0.0000294 AC XY: 4 AN XY: 135892

Gnomad AFR exome AF: 0.00

Gnomad AMR exome AF: 0.00

Gnomad ASJ exome AF: 0.00

Gnomad EAS exome AF: 0.00

Gnomad SAS exome AF: 0.00

Gnomad FIN exome AF: 0.00

Gnomad NFE exome AF: 0.0000703

Gnomad OTH exome AF: 0.000163

GnomAD4 exome AF: 0.0000192 AC: 28 AN: 1461880 Hom.: 0 AF XY: 0.0000179 AC XY: 13 AN XY: 727240

Gnomad4 AFR exome AF: 0.00

Gnomad4 AMR exome AF: 0.00

Gnomad4 ASJ exome AF: 0.00

Gnomad4 EAS exome AF: 0.00

Gnomad4 SAS exome AF: 0.00

Gnomad4 FIN exome AF: 0.00

Gnomad4 NFE exome AF: 0.0000243

Gnomad4 OTH exome AF: 0.0000166

GnomAD4 genome AF: 0.0000131 AC: 2 AN: 152126 Hom.: 0 Cov.: 32 AF XY: 0.0000269 AC XY: 2 AN XY: 74310

Gnomad4 AFR AF: 0.00

Gnomad4 AMR AF: 0.00

Gnomad4 ASJ AF: 0.00

Gnomad4 EAS AF: 0.00

Gnomad4 SAS AF: 0.00

Gnomad4 FIN AF: 0.00

Gnomad4 NFE AF: 0.0000294

Gnomad4 OTH AF: 0.00

Bravo AF: 0.0000113

EpiCase AF: 0.000109

EpiControl AF: 0.00

ClinVar

Significance: Pathogenic

Submissions summary: Pathogenic:47

Revision: criteria provided, multiple submitters, no conflicts

Submissions by phenotype

not provided Pathogenic:14

Pathogenic, no assertion criteria provided	curation	Leiden Open Variation Database	Feb 28, 2020	Curators: Marc Tischkowitz, Arleen D. Auerbach. Submitters to LOVD: Andreas Laner, Marc Tischkowitz. -
Pathogenic, criteria provided, single submitter	clinical testing	CeGaT Center for Human Genetics Tuebingen	May 01, 2020	- -
Pathogenic, no assertion criteria provided	clinical testing	Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen	-	- -
Pathogenic, criteria provided, single submitter	clinical testing	Clinical Genetics Laboratory, Skane University Hospital Lund	Dec 15, 2023	- -
Pathogenic, criteria provided, single submitter	clinical testing	GeneDx	Jun 15, 2020	Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; Observed in individuals with breast and pancreatic cancers and is a recurrent pathogenic variant in Central and Eastern European populations (Dansonka-Mieszkowska 2010, Slater 2010, Casadei 2011, Noskowicz 2014, Cybulski 2015, Wojcik 2016, Kluska 2017, Hilz 2019); Case control studies suggest this variant is associated with breast cancer (Cybulski 2015); Not observed at a significant frequency in large population cohorts (Lek 2016); This variant is associated with the following publications: (PMID: 28407996, 26720728, 23935381, 20122277, 20412113, 21285249, 26843898, 24061862, 27038244, 28279176, 28709830, 27488870, 27757719, 27624329, 27099641, 27106063, 25330149, 26270727, 20582465, 28158555, 25959805, 29478780, 29052111, 30086788, 30833416, 31159747, 30113427, 31312277, 31570822, 29625052, 26689913, 32885271, 32554798) -
Pathogenic, no assertion criteria provided	clinical testing	Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center	-	- -
Pathogenic, no assertion criteria provided	clinical testing	Clinical Genetics Laboratory, Department of Pathology, Netherlands Cancer Institute	-	- -
Pathogenic, no assertion criteria provided	clinical testing	Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+	-	- -
Pathogenic, criteria provided, single submitter	clinical testing	Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital	Mar 04, 2025	- -
Pathogenic, no assertion criteria provided	clinical testing	Genome Diagnostics Laboratory, Amsterdam University Medical Center	-	- -
Pathogenic, criteria provided, single submitter	clinical testing	Quest Diagnostics Nichols Institute San Juan Capistrano	Aug 20, 2021	This frameshift variant causes the premature termination of PALB2 protein synthesis. In addition, it has been identified in individuals with breast, ovarian and pancreatic cancers as well as in healthy controls in the published literature (PMID: 28279176 (2017), 27106063 (2016), 27038244 (2016), 26720728 (2016), 26270727 (2015), 26083025 (2015), 25959805 (2015), 25452441 (2015), 25330149 (2015), 25186627 (2015), 25099575 (2014), 24415441 (2014), 24136930 (2013), 24061862 (2014), 21285249 (2011), 21165770 (2011), 20582465 (2011), 20412113 (2010), 20122277 (2010)). Functional studies in the published literature report this variant reduced DNA binding and failed to stimulate RAD51-mediated strand invasion (PMID: 28158555 (2017)). Based on the available information, this variant is classified as pathogenic. -
Pathogenic, criteria provided, single submitter	clinical testing	Genetic Services Laboratory, University of Chicago	Nov 21, 2017	This pathogenic sequence change results in an amino acid frameshift and creates a premature stop codon 13 amino acids downstream of the mutation, p.Arg170Ilefs*14. This pathogenic sequence change is predicted to result in an abnormal transcript, which may be degraded, or may lead to the production of a truncated PALB2 protein with potentially abnormal function. This pathogenic sequence change has previously been described in patients with PALB2-related breast, ovarian and pancreatic cancers (Dansonka-Mieszkowska et al. 2010; Slater et al. 2010; Casadei et al. 2011; Bogdanova et al. 2011; Adank et al. 2011; Noskowicz et al. 2014; Kluska et al. 2017). Additionally, a breast cancer patient with t-MN was reported to have a different pathogenic PALB2 mutation (Churpek et al. 2016). This pathogenic sequence change may be the germline predisposition to this patient's therapy-related myeloid neoplasm (t-NM), however functional studies have not been performed to prove this conclusively. Compound heterozygous pathogenic variants in PALB2 have been associated with Fanconi anemia of complementation group N [OMIM#610832]. Heterozygous pathogenic variants in PALB2 have been associated with increased susceptibility to cancers including breast cancer [OMIM#114480] and pancreatic cancer [OMIM#613348]. -
Pathogenic, criteria provided, single submitter	clinical testing	Institute for Clinical Genetics, University Hospital TU Dresden, University Hospital TU Dresden	Nov 03, 2021	- -
Pathogenic, criteria provided, single submitter	clinical testing	Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen	Oct 23, 2020	- -

Familial cancer of breast Pathogenic:11

Pathogenic, criteria provided, single submitter	clinical testing	Counsyl	Nov 02, 2016	- -
Pathogenic, criteria provided, single submitter	clinical testing	MGZ Medical Genetics Center	Jul 07, 2022	- -
Pathogenic, criteria provided, single submitter	clinical testing	Myriad Genetics, Inc.	Mar 31, 2023	This variant is considered pathogenic. This variant creates a frameshift predicted to result in premature protein truncation. -
Pathogenic, criteria provided, single submitter	clinical testing	Baylor Genetics	Mar 25, 2024	- -
Pathogenic, criteria provided, single submitter	clinical testing	Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine	Aug 24, 2022	The p.Arg170IlefsX14 variant in PALB2 has been reported in numerous individuals with PABL2-associated cancers, including familial breast, ovarian, and pancreatic cancer and is considered to be a founder variant of central and eastern European origin (selected references: Dansonka-Mieszkowska 2010 PMID: 20122277, Slater 2010 PMID: 20412113, Casadei 2011 PMID: 21285249, Noskowicz 2014 PMID: 24061862, Cybulski 2015 PMID: 25330149, Kluska 2017 PMID: 28279176). This variant has also been reported by other clinical laboratories in ClinVar (Variation ID 126757) and has been identified in 0.001% (2/68010) of European chromosomes by gnomAD (http://gnomad.broadinstitute.org, v.3.1). This variant is predicted to cause a frameshift, which alters the protein’s amino acid sequence beginning at position 170 and leads to a premature termination codon 14 amino acids downstream. This alteration is then predicted to lead to a truncated or absent protein. Loss of function of the PALB2 gene is an established disease mechanism in PALB2-associated cancers, including autosomal dominant breast cancer. In summary, this variant meets criteria to be classified as pathogenic for autosomal dominant PALB2-associated cancers. ACMG/AMP Criteria applied: PVS1, PS4, PM2_Supporting. -
Pathogenic, criteria provided, single submitter	clinical testing	Labcorp Genetics (formerly Invitae), Labcorp	Feb 03, 2025	This sequence change creates a premature translational stop signal (p.Arg170Ilefs*14) in the PALB2 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in PALB2 are known to be pathogenic (PMID: 17200668, 17200671, 17200672, 24136930, 25099575). This variant is present in population databases (rs515726124, gnomAD 0.007%). This premature translational stop signal has been observed in individual(s) with breast, ovarian, and pancreatic cancer (PMID: 20122277, 20412113, 21285249, 24061862, 25330149, 25959805, 26083025, 27038244, 27106063). ClinVar contains an entry for this variant (Variation ID: 126757). For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, criteria provided, single submitter	clinical testing	Institute of Human Genetics, University of Leipzig Medical Center	Sep 16, 2024	Criteria applied: PVS1,PS4 -
Pathogenic, no assertion criteria provided	clinical testing	Pathway Genomics	Nov 06, 2014	- -
Pathogenic, criteria provided, single submitter	research	Centre for Mendelian Genomics, University Medical Centre Ljubljana	Dec 09, 2022	PVS1, PS3, PS4_STR -
Pathogenic, no assertion criteria provided	clinical testing	Clinical Genetics Laboratory, University Hospital Schleswig-Holstein	May 02, 2022	- -
Pathogenic, criteria provided, single submitter	clinical testing	Department of Molecular Diagnostics, Institute of Oncology Ljubljana	Apr 02, 2020	- -

Hereditary cancer-predisposing syndrome Pathogenic:7

Pathogenic, criteria provided, single submitter	clinical testing	Color Diagnostics, LLC DBA Color Health	Mar 06, 2023	This variant deletes 2 nucleotides in exon 4 of the PALB2 gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. A functional study reported that this variant impacts PALB2 binding to DNA (PMID: 28158555). This variant has been detected in over 40 individuals affected with breast, ovarian and pancreatic cancer (PMID: 20122277, 20412113, 20582465, 21285249, 24136930, 24061862, 25099575, 25186627, 26270727, 27106063, 33471991; Leiden Open Variation Database DB-ID PALB2_010036). This variant has been identified in 9/251446 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of PALB2 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
Pathogenic, criteria provided, single submitter	clinical testing	Institute for Biomarker Research, Medical Diagnostic Laboratories, L.L.C.	Nov 22, 2022	- -
Pathogenic, criteria provided, single submitter	clinical testing	Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet	Feb 04, 2025	PVS1; PM5_SUP; PS4_SUP -
Pathogenic, criteria provided, single submitter	clinical testing	Ambry Genetics	Oct 28, 2024	The c.509_510delGA pathogenic mutation, located in coding exon 4 of the PALB2 gene, results from a deletion of two nucleotides at nucleotide positions 509 to 510, causing a translational frameshift with a predicted alternate stop codon (p.R170Ifs*14). This alteration has been reported in familial breast, ovarian, and pancreatic cancer cohorts with carrier ethnicity data supporting c.509_510delGA as a founder mutation of central European origin (Dansonka-Mieszkowska A et al. BMC Med. Genet. 2010 Feb;11:20; Slater EP et al. Clin. Genet. 2010 Nov;78:490-4; Casadei S et al. Cancer Res. 2011 Mar;71:2222-9; Noskowicz M et al. Fam. Cancer. 2014 Jun;13:137-42; Cybulski C et al. Clin. Genet. 2015 Oct;88:366-70; Desmond A et al. JAMA Oncol. 2015 Oct;1:943-51; Kluska A et al. BMC Med. Genomics. 2017 Mar;10:14). Additional data has led authors to suggest that this is one of two PALB2 founder mutations associated with poor outcome in Polish breast cancer patients (Cybulski C et al. Lancet Oncol. 2015 Jun;16:638-44). Further, a functional characterization of this alteration showed that the truncated protein results in weakly bound DNA substrates, suggesting that the loss of the second DNA binding domain affects the affinity for DNA, resulting in significantly impaired DNA binding (Pauty J et al. Nucleic Acids Res. 2017 Mar;45:2644-2657). In addition to the clinical data presented in the literature, this alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -
Pathogenic, criteria provided, single submitter	clinical testing	University of Washington Department of Laboratory Medicine, University of Washington	Nov 20, 2015	- -
Pathogenic, criteria provided, single submitter	clinical testing	GeneKor MSA	Jan 01, 2020	This mutation is a 2 bp deletion at codon 509 of the PALB2 gene. It results in a frame-shift creating new stop codon 14 amino acid residues later, thus resulting in absent or disrupted protein product. Truncating variants in PALB2 are known to be pathogenic. This particular truncation has been reported in the literature in association with familial breast and pancreatic cancers (PMID: 20412113; PMID: 21285249). The mutation database ClinVar contains multiple entries for this variant (Variation ID: 126757). -
Pathogenic, criteria provided, single submitter	clinical testing	Mendelics	Jul 02, 2018	- -

Breast and/or ovarian cancer Pathogenic:2

Pathogenic, criteria provided, single submitter	clinical testing	CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario	May 26, 2022	- -
Pathogenic, no assertion criteria provided	clinical testing	CZECANCA consortium	Jun 11, 2019	- -

PALB2-related disorder Pathogenic:2

Pathogenic, no assertion criteria provided	clinical testing	PreventionGenetics, part of Exact Sciences	Jul 23, 2024	The PALB2 c.509_510delGA variant is predicted to result in a frameshift and premature protein termination (p.Arg170Ilefs*14). This variant has been reported in multiple unrelated individuals with breast and/or ovarian cancer (see for example - Dansonka-Mieszkowska et al. 2010. PubMed ID: 20122277; Casadei et al. 2011. PubMed ID: 21285249; Cybulski et al. 2015. PubMed ID: 25330149). This variant is reported in 0.0070% of alleles in individuals of European (non-Finnish) descent in gnomAD and is interpreted as pathogenic in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/126757/). Frameshift variants in PALB2 are expected to be pathogenic. This variant is interpreted as pathogenic. -
Pathogenic, criteria provided, single submitter	clinical testing	Illumina Laboratory Services, Illumina	Apr 27, 2017	The PALB2 c.509_510delGA (p.Arg170IlefsTer14) variant results in frameshift and is predicted to result in premature truncation of the protein. The p.Arg170IlefsTer14 variant is reported in at least six studies in which it is found in a heterozygous state in a total of 23 breast cancer patients, two ovarian cancer patients and one pancreatic cancer patient (Dansonka-Mieszkowska et al. 2010; Slater et al. 2010; Casadei et al. 2011; Bogdanova et al. 2011; Adank et al. 2011; Noskowicz et al. 2014). This variant has not been reported in individuals with Fanconi anemia. The p.Arg170IlefsTer14 variant was found in a heterozygous state in one of 5097 controls and is reported at a frequency of 0.00010 in the European (non-Finnish) population of the Exome Aggregation Consortium. The variant creates a premature stop codon which shortens the PALB2 protein to 182 amino acids from 1186 amino acids. This removes the C-terminal domain which contains the WD40 repeats necessary for BRCA2/PALB2 complex formation. Other deletion variants that remove the C-terminal domain of the PALB2 protein have been shown to have highly reduced BRCA2 binding capacity and be defective in the repair of ds breaks and mitomyocin C-induced damages. To date, all PALB2 variants detected in families with breast cancer or Fanconi anemia have been frameshift or nonsense changes leading to a truncated protein. Based on the evidence and the potential impact of frameshift variants, the p.Arg170IlefsTer14 variant is classified as pathogenic for PALB2-related disorders. This variant was observed by ICSL as part of a predisposition screen in an ostensibly healthy population. -

Malignant tumor of breast Pathogenic:2

Pathogenic, no assertion criteria provided	clinical testing	Department of Pathology and Laboratory Medicine, Sinai Health System	-	The PALB2 p.Arg170Ilefs*14 variant was identified in 40 of 17778 proband chromosomes (frequency: 0.002) from American and Central European individuals or families with breast/ovarian cancer, colon or familial pancreatic cancer and was identified in 1 of 13574 control chromosomes (freq: 0.00007) from healthy individuals (Antoniou 2014 , AlDubayan 2018, Bogdanova 2011, Cybulski 2015, Dansonka-Mieszkowska 2010, Kluska 2017, Noskowicz 2014, Slater 2010). The variant was identified in dbSNP (ID: rs515726124) as "With Pathogenic allele", in ClinVar (classified pathogenic by GeneDx, Invitae, Ambry Genetics and 9 other submitters), and LOVD 3.0 (1x) databases. The variant was not identified in the following control databases: the 1000 Genomes Project, the NHLBI GO Exome Sequencing Project, the Exome Aggregation Consortium (August 8th 2016), or the Genome Aggregation Database (Feb 27, 2017). The c.509_510del variant is predicted to cause a frameshift, which alters the protein's amino acid sequence beginning at codon 170 and leads to a premature stop codon 14 codons downstream. This alteration is then predicted to result in a truncated or absent protein and loss of function. Loss of function variants of the PALB2 gene are an established mechanism of disease in PALB2 associated breast cancer and is the type of variant expected to cause the disorder. In summary, based on the above information this variant meets our laboratory’s criteria to be classified as pathogenic. -
Pathogenic, criteria provided, single submitter	clinical testing	Women's Health and Genetics/Laboratory Corporation of America, LabCorp	May 11, 2021	Variant summary: PALB2 c.509_510delGA (p.Arg170IlefsX14) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been classified as pathogenic by our laboratory. The variant allele was found at a frequency of 6.1e-05 in 260850 control chromosomes (gnomAD and publications). This frequency is not higher than expected for a pathogenic variant in PALB2 causing Breast Cancer (6.1e-05 vs 0.00016), allowing no conclusion about variant significance. c.509_510delGA has been reported in the literature in multiple individuals affected with breast cancer, ovarian cancer and pancreatic cancer (e.g. Dansonka-Mieszkowska_2010, Casadei_2011, Noskowicz_2014, Cybulski_2015, Borecka_2016). These data indicate that the variant is very likely to be associated with disease. Experimental evidence evaluating an impact on protein function demonstrated the variant impairs DNA binding ability, fails to stimulate RAD51 and fails to localize to DNA damage sites (Pauty_2017). Nineteen ClinVar submitters (evaluation after 2014) cite the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Breast-ovarian cancer, familial, susceptibility to, 1 Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Institute of Human Genetics, University of Leipzig Medical Center

May 22, 2024

Criteria applied: PVS1,PS4 -

Carcinoma of pancreas Pathogenic:1

Pathogenic, no assertion criteria provided

case-control

CZECANCA consortium

Mar 04, 2021

- -

Breast-ovarian cancer, familial, susceptibility to, 5 Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Baylor Genetics

Feb 28, 2024

- -

Hereditary breast ovarian cancer syndrome Pathogenic:1

Pathogenic, no assertion criteria provided

clinical testing

BRCAlab, Lund University

Aug 26, 2022

- -

Breast carcinoma Pathogenic:1

Pathogenic, no assertion criteria provided

clinical testing

Medical Genetics Laboratory, Umraniye Training and Research Hospital, University of Health Sciences

Aug 09, 2021

- -

not specified Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories

Jul 23, 2018

The PALB2 c.509_510delGA; p.Arg170fs variant (rs515726124) is a recurrent alteration in individuals with breast cancer (Casadel 2011, Cybulski 2015, Cybulski 2015b, Dansonka-Mieszkowska 2010, Kluska 2017, Noskowicz 2014), and is significantly enriched in affected individuals compared to the healthy population (Cybulski 2015). This variant is reported as pathogenic in ClinVar (Variation ID: 126757), and found in the general population with a low overall allele frequency of 0.003% (8/246222 alleles) in the Genome Aggregation Database. This variant causes a frameshift by deleting 2 nucleotides, so it is predicted to result in a truncated protein or mRNA subject to nonsense-mediated decay. Based on available information, this variant is considered to be pathogenic. REFERENCES Casadel S et al. Contribution of inherited mutations in the BRCA2-interacting protein PALB2 to familial breast cancer. Cancer Res. 2011; 71(6):2222-9. Cybulski C et al. Clinical outcomes in women with breast cancer and a PALB2 mutation: a prospective cohort analysis. Lancet Oncol. 2015; 16(6):638-44. Cybulski C et al. Mutations predisposing to breast cancer in 12 candidate genes in breast cancer patients from Poland. Clin Genet. 2015b; 88(4):366-70. Dansonka-Mieszkowska A et al. A novel germline PALB2 deletion in Polish breast and ovarian cancer patients. BMC Med Genet. 2010; 11:20. Kluska A et al. PALB2 mutations in BRCA1/2-mutation negative breast and ovarian cancer patients from Poland. BMC Med Genomics. 2017; 10(1):14. Noskowicz M et al. Prevalence of PALB2 mutation c.509_510delGA in unselected breast cancer patients from Central and Eastern Europe. Fam Cancer. 2014; 13(2):137-42. -

Familial cancer of breast;C1835817:Fanconi anemia complementation group N;C3150547:Pancreatic cancer, susceptibility to, 3 Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Fulgent Genetics, Fulgent Genetics

Mar 16, 2022

- -

Fanconi anemia complementation group N Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Revvity Omics, Revvity

Jun 05, 2019

- -

Pancreatic cancer, susceptibility to, 3;C3469522:Breast cancer, susceptibility to Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Human Genome Sequencing Center Clinical Lab, Baylor College of Medicine

Feb 05, 2019

This c.509_510delGA (p.Arg170Ilefs*14) variant in the PALB2 gene is predicted to introduce a premature translation termination codon. This variant has been reported in multiple unrelated patients affected with breast cancer (PMID 21285249, 24061862, 25330149, 26083025), ovarian cancer (PMID 21285249) and pancreatic cancer (PMID 27106063) and is extremely rare in general population. Therefore, the c.509_510delGA (p.Arg170Ilefs*14) variant in the PALB2 gene is classified as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.0		Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Other links and lift over

dbSNP: rs515726123; hg19: chr16-23647356;