Our verdict is Uncertain significance. Variant got 4 ACMG points: 4P and 0B. PP3_Strong
The NM_007294.4(BRCA1):c.1384G>A(p.Gly462Arg) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000136 in 1,613,866 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G462E) has been classified as Uncertain significance.
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]
Breast-ovarian cancer, familial, susceptibility to, 1 Uncertain:4
Uncertain significance, no assertion criteria provided
clinical testing
Breast Cancer Information Core (BIC) (BRCA1)
Sep 15, 1997
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Uncertain significance, no assertion criteria provided
clinical testing
Sharing Clinical Reports Project (SCRP)
Apr 21, 2009
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Uncertain significance, criteria provided, single submitter
clinical testing
Counsyl
Feb 14, 2017
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Uncertain significance, criteria provided, single submitter
clinical testing
All of Us Research Program, National Institutes of Health
Apr 03, 2023
This missense variant replaces glycine with arginine at codon 462 of the BRCA1 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). A functional study reported that this variant has a modest impact on BRCA1 function in a homology-directed repair assay (PMID: 26689913). This variant has been detected in a breast cancer case-control meta-analysis in 3/60466 cases and 1/53461 unaffected individuals (PMID: 33471991; Leiden Open Variation Database DB-ID BRCA1_000146) and in an individual affected with lung cancer (PMID: 26689913). This variant has been identified in 3/251048 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Uncertain significance, criteria provided, single submitter
clinical testing
Ambry Genetics
Jul 08, 2023
The p.G462R variant (also known as c.1384G>A), located in coding exon 9 of the BRCA1 gene, results from a G to A substitution at nucleotide position 1384. The glycine at codon 462 is replaced by arginine, an amino acid with dissimilar properties. This alteration was described as a pathogenic mutation in a French study; however, data contributing to this classification was not provided (Coulet F et al. Genet Test Mol Biomarkers. 2010; 14:677-90). This alteration was not found to have an impact on splicing using a BRCA1 minigene and RT-PCR assay (Anczukow O et al. Genes Chromosomes Cancer. 2008 May;47(5):418-26). In a functional study this alteration was shown to retain 85% of homology-directed repair activity relative to wild type (Lu C et al. Nat Commun, 2015 Dec;6:10086). This alteration was also identified in 0/87 patients with CS or BRRS and 1/3476 patients from The Cancer Genome Atlas (TCGA) (Yehia L et al. PLoS Genet, 2018 04;14:e1007352). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Uncertain significance, criteria provided, single submitter
clinical testing
Color Diagnostics, LLC DBA Color Health
Mar 21, 2023
This missense variant replaces glycine with arginine at codon 462 of the BRCA1 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). A functional study reported that this variant has a modest impact on BRCA1 function in a homology-directed repair assay (PMID: 26689913). This variant has been detected in a breast cancer case-control meta-analysis in 3/60466 cases and 1/53461 unaffected individuals (PMID: 33471991; Leiden Open Variation Database DB-ID BRCA1_000146) and in an individual affected with lung cancer (PMID: 26689913). This variant has been identified in 3/251048 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Likely benign, criteria provided, single submitter
curation
University of Washington Department of Laboratory Medicine, University of Washington
Mar 23, 2023
Missense variant in a coldspot region where missense variants are very unlikely to be pathogenic (PMID:31911673). -
Hereditary breast ovarian cancer syndrome Uncertain:2
Uncertain significance, criteria provided, single submitter
clinical testing
Labcorp Genetics (formerly Invitae), Labcorp
Jan 09, 2024
This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 462 of the BRCA1 protein (p.Gly462Arg). This variant is present in population databases (rs80357221, gnomAD 0.007%). This missense change has been observed in individual(s) with breast and ovarian cancer (PMID: 34326862, 34855882). ClinVar contains an entry for this variant (Variation ID: 54230). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt BRCA1 protein function with a negative predictive value of 95%. Experimental studies have shown that this missense change does not substantially affect BRCA1 function (PMID: 26689913). 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. -
Uncertain significance, criteria provided, single submitter
clinical testing
St. Jude Molecular Pathology, St. Jude Children's Research Hospital
Oct 11, 2021
The BRCA1 c.1384G>A (p.Gly462Arg) missense change has a maximum subpopulation frequency of 0.0026% in gnomAD v2.1.1 (https://gnomad.broadinstitute.org/variant/17-41246164-C-T?dataset=gnomad_r2_1). Seven of seven in silico tools predict a deleterious effect of this variant on protein function (PP3), however in vitro functional studies have shown that this variant results in ~85% of homology-directed repair (HDR) activity of the BRCA1 protein compared to wild-type (PMID: 26689913). This variant has been reported in individuals with urothelial carcinoma, head and neck squamous cell carcinoma, lung squamous cell carcinoma, and skin cutaneous melanoma (PMID: 29625052). In addition, two individuals with this variant are reported in a database of women older than 70 years of age who have never had cancer (FLOSSIES database https://whi.color.com/variant/17-41246164-C-T). In summary, this variant meets criteria to be classified as of uncertain significance based on the ACMG/AMP criteria: PP3, BS3. -
not specified Uncertain:1
Uncertain significance, criteria provided, single submitter
clinical testing
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Apr 21, 2023
Variant summary: BRCA1 c.1384G>A (p.Gly462Arg) results in a non-conservative amino acid change located in the BRCA1, serine-rich domain (IPR025994) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 1.2e-05 in 251048 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.1384G>A has been reported in the literature in individuals affected with breast and/or ovarian cancer (e.g. Anczukow_2008, Coulet_2010). These reports do not provide unequivocal conclusions about association of the variant with Hereditary Breast And Ovarian Cancer Syndrome. At least one publication reports experimental evidence evaluating an impact on protein function and found that the variant resulted in 85%-90% of normal homology directed repair (HDR) activity (Lu_2015). In addition, a multifactorial model including cosegregation data from affected families predicted this variant to be benign (Caputo_2021). Seven submitters have provided clinical-significance assessments for this variant to ClinVar after 2014 and classified the variant as VUS (n=6) or likely benign (n=1). Based on the evidence outlined above, the variant was classified as VUS-possibly benign. -
Breast and/or ovarian cancer Uncertain:1
Uncertain significance, no assertion criteria provided
research
CSER _CC_NCGL, University of Washington
Jun 01, 2014
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not provided Uncertain:1
Uncertain significance, criteria provided, single submitter
clinical testing
GeneDx
Jan 24, 2023
Not observed at a significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Published functional studies are inconclusive: reduced, but not absent, homology-directed repair activity (Lu et al., 2015); Multifactorial analysis suggests that this variant is benign (Caputo et al., 2021); Observed in individuals with melanoma, bladder or lung cancer (Lu et al., 2015; Huang et al., 2018; Yehia et al., 2018); Also known as 1503G>A; This variant is associated with the following publications: (PMID: 18273839, 15385441, 20858050, 16518693, 15001988, 12531920, 25637381, 23704879, 23893897, 29684080, 29625052, 26689913, 34597585, 15343273) -
BRCA1-related disorder Uncertain:1
Uncertain significance, no assertion criteria provided
clinical testing
PreventionGenetics, part of Exact Sciences
Oct 30, 2023
The BRCA1 c.1384G>A variant is predicted to result in the amino acid substitution p.Gly462Arg. This variant has been reported in individuals with breast/ovarian cancer, bladder urothelial carcinoma, head and neck squamous cell carcinoma, lung squamous cell carcinoma, skin cutaneous melanoma, Cowden/Cowden-like and Bannayan-Riley-Ruvalcaba syndromes (BRRS) (Anczuków et al. 2008. PubMed ID: 18273839. Table S1; Coulet et al. 2010. PubMed ID: 20858050; Lu et al. 2015. PubMed ID: 26689913. Table S12; Huang et al. 2018. PubMed ID: 29625052. Table S2B; Yehia et al. 2018. PubMed ID: 29684080. Table S9). Functional studies showed that this variant does not have an impact on splicing using a BRCA1 minigene and RT-PCR assay (Anczuków et al. 2008. PubMed ID: 18273839. Table S1) and retains 85% of wild type repair function (Lu et al. 2015. PubMed ID: 26689913. Table S22). This variant is reported in 0.0026% of alleles in individuals of European (Non-Finnish) descent in gnomAD (http://gnomad.broadinstitute.org/variant/17-41246164-C-T). In ClinVar, this variant has conflicting interpretations, including likely benign and uncertain (https://www.ncbi.nlm.nih.gov/clinvar/variation/54230/). At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -