Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PS1_Very_StrongPM1PM5
The NM_007294.4(BRCA1):c.5339_5340delTGinsGC(p.Leu1780Arg) variant causes a missense change. The variant was absent in control chromosomes in GnomAD project. It is difficult to determine the true allele frequency of this variant because it is of type MNV, and the frequency of such variant types in population databases may be underestimated and unreliable. No clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar. Another nucleotide change resulting in the same amino acid substitution has been previously reported as Likely pathogenic in ClinVar. Another variant affecting the same amino acid position, but resulting in a different missense (i.e. L1780V) has been classified as Uncertain significance. The gene BRCA1 is included in the ClinGen Criteria Specification Registry.
BRCA1 (HGNC:1100): (BRCA1 DNA repair associated) This gene encodes a 190 kD nuclear phosphoprotein that plays a role in maintaining genomic stability, and it also acts as a tumor suppressor. The BRCA1 gene contains 22 exons spanning about 110 kb of DNA. The encoded protein combines with other tumor suppressors, DNA damage sensors, and signal transducers to form a large multi-subunit protein complex known as the BRCA1-associated genome surveillance complex (BASC). This gene product associates with RNA polymerase II, and through the C-terminal domain, also interacts with histone deacetylase complexes. This protein thus plays a role in transcription, DNA repair of double-stranded breaks, and recombination. Mutations in this gene are responsible for approximately 40% of inherited breast cancers and more than 80% of inherited breast and ovarian cancers. Alternative splicing plays a role in modulating the subcellular localization and physiological function of this gene. Many alternatively spliced transcript variants, some of which are disease-associated mutations, have been described for this gene, but the full-length natures of only some of these variants has been described. A related pseudogene, which is also located on chromosome 17, has been identified. [provided by RefSeq, May 2020]
BRCA1 Gene-Disease associations (from GenCC):
BRCA1-related cancer predisposition
Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
breast-ovarian cancer, familial, susceptibility to, 1
Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Ambry Genetics
Our verdict: Pathogenic. The variant received 12 ACMG points.
PS1
Transcript NM_007294.4 (BRCA1) is affected with MISSENSE_VARIANT having same AA change as one Pathogenic present in ClinVar.
PM1
In a hotspot region, there are 16 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 14 benign, 84 uncertain in NM_007294.4
PM5
Other missense variant is known to change same aminoacid residue: Variant chr17-43049188-A-G is described in ClinVar as Pathogenic/Likely_pathogenic. ClinVar VariationId is 55541.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
Variant Effect in Transcripts
ACMG analysis was done for transcript: NM_007294.4. You can select a different transcript below to see updated ACMG assignments.
RefSeq Transcripts
Sel.
Gene
Transcript
Tags
HGVSc
HGVSp
Effect
Exon Rank
Protein
UniProt
BRCA1
NM_007294.4
MANE Select
c.5339_5340delTGinsGC
p.Leu1780Arg
missense
N/A
NP_009225.1
P38398-1
BRCA1
NM_001407581.1
c.5405_5406delTGinsGC
p.Leu1802Arg
missense
N/A
NP_001394510.1
A0A2R8Y7V5
BRCA1
NM_001407582.1
c.5405_5406delTGinsGC
p.Leu1802Arg
missense
N/A
NP_001394511.1
A0A2R8Y7V5
Ensembl Transcripts
Sel.
Gene
Transcript
Tags
HGVSc
HGVSp
Effect
Exon Rank
Protein
UniProt
BRCA1
ENST00000357654.9
TSL:1 MANE Select
c.5339_5340delTGinsGC
p.Leu1780Arg
missense
N/A
ENSP00000350283.3
P38398-1
BRCA1
ENST00000471181.7
TSL:1
c.5402_5403delTGinsGC
p.Leu1801Arg
missense
N/A
ENSP00000418960.2
P38398-7
BRCA1
ENST00000470026.6
TSL:1
c.5339_5340delTGinsGC
p.Leu1780Arg
missense
N/A
ENSP00000419274.2
P38398-1
Frequencies
GnomAD3 genomes
Cov.:
31
We have no GnomAD4 exomes data on this position. Probably position not covered by the project.