Our verdict is Likely pathogenic. Variant got 8 ACMG points: 8P and 0B. PM1PM2PM5PP3_Moderate
The NM_007294.4(BRCA1):c.4957G>A(p.Val1653Met) variant causes a missense change. 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 Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. V1653G) 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]
Verdict is Likely_pathogenic. Variant got 8 ACMG points.
PM1
In a hotspot region, there are 3 aminoacids with missense pathogenic changes in the window of +-8 aminoacids around while only 7 benign, 17 uncertain in NM_007294.4
PM2
Very rare variant in population databases, with high coverage;
PM5
Other missense variant is known to change same aminoacid residue: Variant chr17-43070956-A-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 868875.Status of the report is criteria_provided_single_submitter, 1 stars.
PP3
MetaRNN computational evidence supports a deleterious effect, 0.864
Uncertain significance, criteria provided, single submitter
clinical testing
Ambry Genetics
Oct 30, 2020
The p.V1653M variant (also known as c.4957G>A), located in coding exon 14 of the BRCA1 gene, results from a G to A substitution at nucleotide position 4957. The valine at codon 1653 is replaced by methionine, an amino acid with highly similar properties. This alteration has been identified in multiple breast and/or ovarian cancer cohorts (Hirotsu Y et al. Mol Genet Genomic Med. 2015 Mar;3:121-9; Nakagomi H et al. Cancer Sci. 2018 Feb;109:453-461). This alteration has mixed results in various functional assays including a transcription activation assay where it is non-functional; intermediate effects in binding activity and specificity, and WT-like effects in a yeast-based small colony-forming assay (Coyne RS et al. Cancer Biol. Ther. 2004 May;3:453-7; Lee MS et al. Cancer Res. 2010 Jun;70:4880-90; Fernandes VC et al. J Biol Chem. 2019 04;294:5980-5992). 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. -
Hereditary breast ovarian cancer syndrome Uncertain:1
Uncertain significance, criteria provided, single submitter
clinical testing
Invitae
Oct 18, 2021
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. Experimental studies have shown that this missense change affects BRCA1 function (PMID: 15004537, 20516115, 28781887). Algorithms developed to predict the effect of missense changes on protein structure and function are either unavailable or do not agree on the potential impact of this missense change (SIFT: "Deleterious"; PolyPhen-2: "Probably Damaging"; Align-GVGD: "Class C0"). ClinVar contains an entry for this variant (Variation ID: 55331). This missense change has been observed in individual(s) with breast and/or ovarian cancer (PMID: 9333265). This variant is not present in population databases (ExAC no frequency). This sequence change replaces valine with methionine at codon 1653 of the BRCA1 protein (p.Val1653Met). The valine residue is highly conserved and there is a small physicochemical difference between valine and methionine. -