Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_007294.4(BRCA1):c.1193C>G(p.Ser398*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★★). Variant results in nonsense mediated mRNA decay.
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]
Verdict is Pathogenic. Variant got 18 ACMG points.
PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 17-43094338-G-C is Pathogenic according to our data. Variant chr17-43094338-G-C is described in ClinVar as [Pathogenic]. Clinvar id is 54160.Status of the report is reviewed_by_expert_panel, 3 stars. Variant chr17-43094338-G-C is described in Lovd as [Pathogenic]. Variant chr17-43094338-G-C is described in Lovd as [Pathogenic].
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The p.S398* pathogenic mutation (also known as c.1193C>G), located in coding exon 9 of the BRCA1 gene, results from a C to G substitution at nucleotide position 1193. This changes the amino acid from a serine to a stop codon within coding exon 9. A different alteration that also results in truncation at this position, c.1193C>A, was reported in a healthy 34 year-old woman with a family history of breast and ovarian cancer (Novakovi S et al. Int. J. Oncol., 2012 Nov;41:1619-27). The p.S398* 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. -
Ovarian neoplasm Pathogenic:1
Dec 01, 2018
German Consortium for Hereditary Breast and Ovarian Cancer, University Hospital Cologne
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research
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Hereditary breast ovarian cancer syndrome Pathogenic:1
Jun 06, 2018
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
For these reasons, this variant has been classified as Pathogenic. Loss-of-function variants in BRCA1 are known to be pathogenic (PMID: 20104584). This variant has been observed in a family affected with breast and/or ovarian cancer (PMID: 22923021). ClinVar contains an entry for this variant (Variation ID: 54160). This variant is not present in population databases (ExAC no frequency). This sequence change creates a premature translational stop signal (p.Ser398*) in the BRCA1 gene. It is expected to result in an absent or disrupted protein product. -