chr17-43106456-C-G
Variant summary
Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PM1PM2PM5PP3_StrongPP5_Very_Strong
The NM_007294.4(BRCA1):c.212G>C(p.Arg71Thr) variant causes a missense, splice region change. The variant was absent in control chromosomes in GnomAD project. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R71S) has been classified as Uncertain significance.
Frequency
Consequence
NM_007294.4 missense, splice_region
Scores
Clinical Significance
Conservation
Publications
- breast-ovarian cancer, familial, susceptibility to, 1Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, ClinGen, Labcorp Genetics (formerly Invitae), Genomics England PanelApp
- Fanconi anemia, complementation group SInheritance: AR Classification: DEFINITIVE, STRONG, MODERATE, LIMITED Submitted by: G2P, Labcorp Genetics (formerly Invitae), ClinGen, Ambry Genetics
- pancreatic cancer, susceptibility to, 4Inheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- hereditary breast ovarian cancer syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Fanconi anemiaInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
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ACMG classification
Our verdict: Pathogenic. The variant received 18 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| BRCA1 | NM_007294.4 | c.212G>C | p.Arg71Thr | missense_variant, splice_region_variant | Exon 4 of 23 | ENST00000357654.9 | NP_009225.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| BRCA1 | ENST00000357654.9 | c.212G>C | p.Arg71Thr | missense_variant, splice_region_variant | Exon 4 of 23 | 1 | NM_007294.4 | ENSP00000350283.3 |
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD4 exome Cov.: 28
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
Breast-ovarian cancer, familial, susceptibility to, 1 Pathogenic:2
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Hereditary cancer-predisposing syndrome Pathogenic:2
This variant alters the conserved guanine at the last nucleotide position of exon 4 of the BRCA1 gene. This variant is also known as 331G>C in exon 5 according to the BIC nomenclature and exon naming system. This variant is predicted to disrupt the reference intron 4 splice donor site and also to activate an out-of-frame cryptic donor site (PMID: 35449021). Two other mutations c.212G>A and c.211A>G have been shown to cause out-of-frame splicing (PMID: 11385711, 20215541, 21863257, 22505045, 23451180) and also the in-frame skipping of exon 4 impacting the functionally important RING domain (PMID: 21863257). These aberrant spliced transcript are expected to produce an absent or nonfunctional protein product. Functional studies have reported findings consistent with this variant causing unstable mRNA thus impacting BRCA1 function (PMID: 30209399), whereas the variant protein change (p.Arg71Thr) on its own had no impact on BARD1 binding and E3 ligase assays (PMID: 25823446, 35659930). This variant has been reported in an individual affected with ovarian cancer (PMID: 29053726). Similar variants c.211A>G and c.212G>A have been reported in individuals and families affected with breast or ovarian cancer (PMID: 11385711, 11802209, 21863257, 23683081, 25480878, 26577449, 27081505, 28724667, 29435039, 29752822, 30078507) and c.211A>G also has been reported to segregate with disease with a likelihood ratio for pathogenicity of 383.2656 (PMID: 31131967). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Loss of BRCA1 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
The c.212G>C pathogenic mutation (also known as p.R71T), located in coding exon 3 of the BRCA1 gene, results from a G to C substitution at nucleotide position 212. The arginine at codon 71 is replaced by threonine, an amino acid with similar properties. This change occurs in the last base pair of coding exon 3, which makes it likely to have some effect on normal mRNA splicing. This alteration was identified in an individual diagnosed with ovarian cancer (Harter P et al. PLoS ONE, 2017 Oct;12:e0186043) and in a large, worldwide study of BRCA1/2 mutation positive families (Rebbeck TR et al. Hum. Mutat., 2018 05;39:593-620). RNA studies have demonstrated that this alteration results in abnormal splicing in the set of samples tested (Ambry internal data).One functional study found that this nucleotide substitution is non-functional in a high throughput genome editing haploid cell survival assay (Findlay GM et al. Nature, 2018 10;562:217-222). Another alteration impacting the same donor site (p.R71G, c.211A>G) has been has been shown to have a similar impact on splicing (Ambry internal data; Sanz DJ et al. Clin. Cancer Res. 2010 Mar;16:1957-67; Houdayer C et al. Hum. Mutat. 2012 Aug;33:1228-38).This nucleotide position is highly conserved in available vertebrate species. In silico splice site analysis predicts that this alteration will weaken the native splice donor site. Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
Ovarian neoplasm Pathogenic:1
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Hereditary breast ovarian cancer syndrome Pathogenic:1
This sequence change replaces arginine, which is basic and polar, with threonine, which is neutral and polar, at codon 71 of the BRCA1 protein (p.Arg71Thr). This variant also falls at the last nucleotide of exon 4, which is part of the consensus splice site for this exon. This variant is not present in population databases (gnomAD no frequency). This variant has not been reported in the literature in individuals affected with BRCA1-related conditions. ClinVar contains an entry for this variant (Variation ID: 267512). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. Experimental studies have shown that this missense change affects BRCA1 function (PMID: 30209399). Variants that disrupt the consensus splice site are a relatively common cause of aberrant splicing (PMID: 17576681, 9536098). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. This variant disrupts the p.Arg71 amino acid residue in BRCA1. Other variant(s) that disrupt this residue have been determined to be pathogenic (Invitae). 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. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at