Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_007294.4(BRCA1):c.754del(p.Arg252ValfsTer46) variant causes a frameshift change. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. R252R) has been classified as Benign. 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 17-43094776-CG-C is Pathogenic according to our data. Variant chr17-43094776-CG-C is described in ClinVar as [Pathogenic]. Clinvar id is 496401.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr17-43094776-CG-C is described in Lovd as [Pathogenic]. Variant chr17-43094776-CG-C is described in Lovd as [Pathogenic].
Hereditary breast ovarian cancer syndrome Pathogenic:2
Pathogenic, criteria provided, single submitter
clinical testing
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Jun 16, 2017
Variant summary: The BRCA1 c.754delC (p.Arg252Valfs) variant results in a premature termination codon, predicted to cause a truncated or absent BRCA1 protein due to nonsense mediated decay, which are commonly known mechanisms for disease. Truncations downstream of this position have been classified as pathogenic by our laboratory (e.g., c.783T>G [p.Tyr261X], c.784delC [p.Gln262fs). The variant has been identified in at least two patients with triple-negative breast cancer (Lang_BRCA1&2_IJC_2017; Yang_PLoS One_2015) and is absent from the large control database ExAC and control cohorts reported in the literature (0/122396 control chromosomes). One in silico tool predicts a damaging outcome for this variant. Taken together, this variant is classified as pathogenic. -
Pathogenic, criteria provided, single submitter
clinical testing
Labcorp Genetics (formerly Invitae), Labcorp
Dec 16, 2023
This sequence change creates a premature translational stop signal (p.Arg252Valfs*46) in the BRCA1 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in BRCA1 are known to be pathogenic (PMID: 20104584). This variant is not present in population databases (gnomAD no frequency). This premature translational stop signal has been observed in individual(s) with hereditary breast and ovarian cancer syndrome (PMID: 25927356). ClinVar contains an entry for this variant (Variation ID: 496401). For these reasons, this variant has been classified as Pathogenic. -
The c.754delC pathogenic mutation, located in coding exon 9 of the BRCA1 gene, results from a deletion of one nucleotide at nucleotide position 754, causing a translational frameshift with a predicted alternate stop codon. This pathogenic mutation has been reported in a Chinese individual diagnosed with breast cancer at age 35 (Yang X et al. PLoS ONE, 2015 Apr;10:e0125571). In addition to the clinical data presented in the literature, this 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. -