chr13-32370448-G-A

Variant summary

Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PM2PM5PP3_StrongPP5_Very_Strong

The NM_000059.4(BRCA2):​c.8378G>A​(p.Gly2793Glu) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.000000684 in 1,461,706 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 Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. G2793E?) has been classified as Pathogenic.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 6.8e-7 ( 0 hom. )

Consequence

BRCA2
NM_000059.4 missense

Scores

12
3
1

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:12U:2

Conservation

PhyloP100: 9.94
Variant links:
Genes affected
BRCA2 (HGNC:1101): (BRCA2 DNA repair associated) Inherited mutations in BRCA1 and this gene, BRCA2, confer increased lifetime risk of developing breast or ovarian cancer. Both BRCA1 and BRCA2 are involved in maintenance of genome stability, specifically the homologous recombination pathway for double-strand DNA repair. The largest exon in both genes is exon 11, which harbors the most important and frequent mutations in breast cancer patients. The BRCA2 gene was found on chromosome 13q12.3 in human. The BRCA2 protein contains several copies of a 70 aa motif called the BRC motif, and these motifs mediate binding to the RAD51 recombinase which functions in DNA repair. BRCA2 is considered a tumor suppressor gene, as tumors with BRCA2 mutations generally exhibit loss of heterozygosity (LOH) of the wild-type allele. [provided by RefSeq, May 2020]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 16 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr13-32370447-GG-GAA is described in Lovd as [Pathogenic].
PP3
MetaRNN computational evidence supports a deleterious effect, 0.967
PP5
Variant 13-32370448-G-A is Pathogenic according to our data. Variant chr13-32370448-G-A is described in ClinVar as [Likely_pathogenic]. Clinvar id is 38157.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
BRCA2NM_000059.4 linkuse as main transcriptc.8378G>A p.Gly2793Glu missense_variant 19/27 ENST00000380152.8 NP_000050.3

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
BRCA2ENST00000380152.8 linkuse as main transcriptc.8378G>A p.Gly2793Glu missense_variant 19/275 NM_000059.4 ENSP00000369497 A2

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
AF:
6.84e-7
AC:
1
AN:
1461706
Hom.:
0
Cov.:
31
AF XY:
0.00000138
AC XY:
1
AN XY:
727160
show subpopulations
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:
0.00
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:12Uncertain:2
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Hereditary breast ovarian cancer syndrome Pathogenic:4
Pathogenic, criteria provided, single submitterclinical testingCancer Variant Interpretation Group UK, Institute of Cancer Research, LondonFeb 14, 2019Data used in classification: Case control comparison of UK familial cases against ethnically matched population data (5/25,773 in familial UK cases against 0/56,856 GNOMAD NFE controls) 2-sided Fishers exact: pexact= 0.0030 (PS4_strong). Absent in the remainder of the gnomAD population (PM2_mod). This variant is predicted deleterious on AlignGVGD (class:C65), SIFT (Deleterious), Polyphen2 HumVar (probably damaging), CADD (29.8), Revel [0-1]: 0.916, Gavin class: Pathogenic, (confidence: genomewide) (PP3_sup). The variant is in the DNA-binding domain of BRCA2 (PM1_sup). In the BRCA2 Homology-Directed Repair Activity assay DNA Binding Domain assay (Guidugli et al Cancer Res 2013;73:265-275,Couch Lab), the variant has a probability of pathogenicity of P=1.0 (PS3_strong). Data not used in classification: There are additional reports of this variant in ClinVar (5), DMuDB (1), BIC(4), and BRCA2 LOVD(1). 5 Classifications on ClinVar as uncertain. Ambry classification: likely pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpMay 08, 2023Variant summary: BRCA2 c.8378G>A (p.Gly2793Glu) results in a non-conservative amino acid change located in the BRCA2 OB1 domain (IPR015187) of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant was absent in 251422 control chromosomes (gnomAD). c.8378G>A has been reported in the literature in individuals affected with Hereditary Breast And/or Ovarian Cancer (example: Butz_2021). The variant of interest has been functionally assessed for effect on splicing and showed that it did influence exon 19 splicing (~15%), with the predominant product being the wild type BRCA2 protein (~85%) (Acedo_2012), additionally, the variant of interest was shown to significantly affect homology-directed repair activity (example: Guidugli_2013, Richardson_2021). Other variants affecting the same amino acid residue is classified pathogenic/likely pathogenic in ClinVar (CV ID 52569, 38158). This suggests that this residue may play a critical role in normal protein function. The following publications have been ascertained in the context of this evaluation (PMID: 22632462, 33672545, 32719484, 23108138, 24323938, 19043619, 33609447). Seven clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 and classified the variant as VUS (n=2) and pathogenic/likely pathogenic (n=5). Based on the evidence outlined above, the variant was classified as likely pathogenic. -
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpJan 19, 2024This sequence change replaces glycine, which is neutral and non-polar, with glutamic acid, which is acidic and polar, at codon 2793 of the BRCA2 protein (p.Gly2793Glu). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with clinical features of BRCA2-related conditions (PMID: 10923033). ClinVar contains an entry for this variant (Variation ID: 38157). Advanced modeling performed at Invitae incorporating data from internal and/or published experimental studies (PMID: 33609447) indicates that this missense variant is expected to disrupt BRCA2 function with a positive predictive value of 95%. Experimental studies have shown that this missense change affects BRCA2 function (PMID: 23108138, 29394989, 29884841). This variant disrupts the p.Gly2793 amino acid residue in BRCA2. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 12442275, 15889636, 16030099, 19043619, 23108138, 23233716, 25085752, 25777348). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -
Likely pathogenic, criteria provided, single submittercurationGerman Consortium for Hereditary Breast and Ovarian Cancer, University Hospital CologneJan 09, 2024. According to the ClinGen ENIGMA BRCA2 v1.0.0 criteria we chose these criteria: PS3 (strong pathogenic): LOF in HRD-Assay (Richardson et al., (PMID:33609447) Own RNA-Analysis in patient derived blood sample revealed biallelic expression of variant in WT-transcript, PM2 (supporting pathogenic): not in gnomAD, PP3 (supporting pathogenic): CADD:29.5 REVEL: 0.916 HCI prior:0.81 BayesDEL:0.583972 spliceAI:BRCA2: 0.05 -
Breast-ovarian cancer, familial, susceptibility to, 2 Pathogenic:2Uncertain:2
Uncertain significance, flagged submissionclinical testingSharing Clinical Reports Project (SCRP)Jul 08, 2010- -
Likely pathogenic, no assertion criteria providedclinical testingBRCAlab, Lund UniversityMar 02, 2020- -
Likely pathogenic, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthJul 19, 2023This missense variant replaces glycine with glutamic acid at codon 2793 of the BRCA2 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). Functional studies have shown that this variant results in impaired homology-directed DNA repair (PMID: 23108138, 29394989, 33609447) and abnormal splicing (PMID: 22632462). This variant has been reported in 3 individuals affected with breast or ovarian cancer (PMID: 33672545, Lovejoy 2018, Color internal data). Another variant at this amino acid (Gly2793Arg) has been classified as pathogenic (ClinVar Variant ID: 52569). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Uncertain significance, flagged submissionclinical testingBreast Cancer Information Core (BIC) (BRCA2)Jul 07, 2000- -
not provided Pathogenic:3
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxJan 31, 2023Published functional studies demonstrate a damaging effect: significantly reduced homologous recombination DNA-repair activity (Guidugli et al., 2013; Guidugli et al., 2018; Iversen et al., 2022); Not observed at significant frequency in large population cohorts (gnomAD); Observed in individuals with breast cancer (Lovejoy et al., 2018; Butz et al., 2021); In silico analysis supports that this missense variant does not alter protein structure/function; Also known as 8606G>A; This variant is associated with the following publications: (PMID: 23108138, 24323938, 32623769, 25382762, 33609447, 33672545, 32170000, 19043619, 22632462, 12228710, 29884841, 32719484, 35665744, 10923033, 29394989) -
Likely pathogenic, criteria provided, single submitterclinical testingPreventionGenetics, part of Exact SciencesApr 12, 2024A hybrid minigene functional assay has demonstrated skipping of exon 19 in the BRCA2 gene from this variant (Acedo et al. 2012. PubMed ID: 22632462). Another functional study shows that this variant causes reduced protein function compared to wildtype (Guidugli et al. 2012. PubMed ID: 23108138). Alternate missense changes at this amino acid (p.Gly2793Arg, p.Gly2793Val) are classified as pathogenic (Richardson et al. 2021. PubMed ID: 33609447). Although the classifications in ClinVar range from uncertain to pathogenic, the vast majority of recent entries are likely pathogenic or pathogenic (https://www.ncbi.nlm.nih.gov/clinvar/variation/38157/). This variant has not been observed in a large population database, indicating this variant is rare. This variant is interpreted as likely pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingQuest Diagnostics Nichols Institute San Juan CapistranoFeb 21, 2024The BRCA2 c.8378G>A (p.Gly2793Glu) variant has been reported in the published literature in an elderly individual with male breast cancer (PMID: 33672545 (2021), and in an individual with female breast cancer who carried a second BRCA2 missense variant (Lovejoy et al. Austin J Cancer Clin Res (2018) 5(1):1082). The c.8378G>A (p.Gly2793Glu) variant has been predicted to be likely deleterious based on protein likelihood ratio modeling (PMID: 19043619 (2008)), and experimental studies indicate it has deleterious effects on BRCA2 homology-directed DNA repair activity (PMIDs: 23108138 (2013), 29394989 (2018), 29884841 (2019)). This variant has not been reported in large, multi-ethnic general populations (Genome Aggregation Database, http://gnomad.broadinstitute.org). Based on the available information, this variant is classified as likely pathogenic. -
Hereditary cancer-predisposing syndrome Pathogenic:2
Likely pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsOct 06, 2023The p.G2793E variant (also known as c.8378G>A), located in coding exon 18 of the BRCA2 gene, results from a G to A substitution at nucleotide position 8378. The glycine at codon 2793 is replaced by glutamic acid, an amino acid with similar properties. This alteration was found to produce exon 19 skipping; however, the majority of transcript produced by this alteration is wildtype (Acedo A et al. Breast Cancer Res. 2012 May;14:R87). This amino acid substitution was shown to be defective in a homology directed repair assays (Guidugli L et al. Cancer Res. 2013 Jan;73:265-75; Guidugli L et al. Am. J. Hum. Genet. 2018 Jan;102:233-248; Hart SN et al. Genet. Med. 2019 01;21:71-80; Richardson ME et al. Am J Hum Genet, 2021 03;108:458-468). Based on internal structural analysis, this alteration is predicted to disrupt binding to DSS1 and is more destabilizing to the local structure than other known pathogenic variants (Ambry internal data). This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthApr 18, 2023This missense variant replaces glycine with glutamic acid at codon 2793 of the BRCA2 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). Functional studies have shown that this variant results in impaired homology-directed DNA repair (PMID: 23108138, 29394989, 33609447) and abnormal splicing (PMID: 22632462). This variant has been reported in 3 individuals affected with breast or ovarian cancer (PMID: 33672545, Lovejoy 2018, Color internal data). Another variant at this amino acid (Gly2793Arg) has been classified as pathogenic (ClinVar Variant ID: 52569). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Familial cancer of breast Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingBaylor GeneticsNov 18, 2022- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.98
BayesDel_addAF
Pathogenic
0.57
D
BayesDel_noAF
Pathogenic
0.58
CADD
Pathogenic
28
DANN
Uncertain
1.0
Eigen
Pathogenic
0.99
Eigen_PC
Pathogenic
0.92
FATHMM_MKL
Pathogenic
0.99
D
M_CAP
Pathogenic
0.84
D
MetaRNN
Pathogenic
0.97
D;D
MetaSVM
Pathogenic
1.1
D
MutationTaster
Benign
1.0
D;D
PrimateAI
Uncertain
0.67
T
PROVEAN
Uncertain
-2.4
N;N
REVEL
Pathogenic
0.92
Sift
Pathogenic
0.0
D;D
Sift4G
Pathogenic
0.0
D;D
Vest4
0.87
MutPred
0.82
Gain of solvent accessibility (P = 0.0374);Gain of solvent accessibility (P = 0.0374);
MVP
0.99
MPC
0.18
ClinPred
1.0
D
GERP RS
5.2
gMVP
0.94

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.050
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

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs80359083; hg19: chr13-32944585; COSMIC: COSV104701295; COSMIC: COSV104701295; API