rs397508006

Variant summary

Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong

The NM_000059.4(BRCA2):​c.8754+1G>A variant causes a splice donor, intron change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Pathogenic (★★).

Frequency

Genomes: not found (cov: 32)

Consequence

BRCA2
NM_000059.4 splice_donor, intron

Scores

5
1
1
Splicing: ADA: 1.000
2

Clinical Significance

Pathogenic criteria provided, multiple submitters, no conflicts P:9

Conservation

PhyloP100: 7.82
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 18 ACMG points.

PVS1
Splicing +-2 bp (donor or acceptor) variant, LoF is a know mechanism of disease, Cryptic splice site detected, with MaxEntScore 5.7, offset of 8, new splice context is: agaGTaaga. Cryptic site results in frameshift change. If cryptic site found is not functional and variant results in exon loss, it results in frameshift change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 13-32376792-G-A is Pathogenic according to our data. Variant chr13-32376792-G-A is described in ClinVar as [Pathogenic]. Clinvar id is 52667.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr13-32376792-G-A is described in Lovd as [Likely_pathogenic]. Variant chr13-32376792-G-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
BRCA2NM_000059.4 linkc.8754+1G>A splice_donor_variant, intron_variant Intron 21 of 26 ENST00000380152.8 NP_000050.3 P51587

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
BRCA2ENST00000380152.8 linkc.8754+1G>A splice_donor_variant, intron_variant Intron 21 of 26 5 NM_000059.4 ENSP00000369497.3 P51587
BRCA2ENST00000530893.7 linkc.8385+1G>A splice_donor_variant, intron_variant Intron 21 of 26 1 ENSP00000499438.2 A0A590UJI7
BRCA2ENST00000614259.2 linkn.*812+1G>A splice_donor_variant, intron_variant Intron 20 of 25 2 ENSP00000506251.1 A0A7P0TAP7

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
Cov.:
32
GnomAD4 genome
Cov.:
32

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:9
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Hereditary breast ovarian cancer syndrome Pathogenic:3
Aug 24, 2018
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Variant summary: BRCA2 c.8754+1G>A is located in a canonical splice-site and is predicted to affect mRNA splicing resulting in a significantly altered protein due to either exon skipping, shortening, or inclusion of intronic material. Several computational tools predict a significant impact on normal splicing: Four predict the variant abolishes a 5 splicing donor site. Exon trapping and RT-PCR analysis of patient blood showed that the mutation activates a cryptic splice site 46 base pairs 3' of exon 21, resulting in the inclusion of a premature stop codon and synthesis of a truncated BRCA2 protein (Hansen_2008). The variant was absent in 245740 control chromosomes (gnomAD). The variant, c.8754+1G>A, has been reported in the literature in individuals affected with Hereditary Breast and Ovarian Cancer, and in one case was reported as a de novo mutation (Francies_2015, Hansen_2008, Solano_2016, Thomassen_2008). These data indicate that the variant is likely to be associated with disease. Three clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Nov 16, 2021
National Health Laboratory Service, Universitas Academic Hospital and University of the Free State
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Jul 14, 2023
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Studies have shown that disruption of this splice site results in insertion of intronic sequence and introduces a premature termination codon (PMID: 18597679). The resulting mRNA is expected to undergo nonsense-mediated decay. For these reasons, this variant has been classified as Pathogenic. ClinVar contains an entry for this variant (Variation ID: 52667). Disruption of this splice site has been observed in individual(s) with breast and/or ovarian cancer (PMID: 18597679, 23199084, 28947987). In at least one individual the variant was observed to be de novo. It is commonly reported in individuals of Austrian ancestry (PMID: 23199084). This variant is not present in population databases (gnomAD no frequency). This sequence change affects a donor splice site in intron 21 of the BRCA2 gene. RNA analysis indicates that disruption of this splice site induces altered splicing and may result in an absent or disrupted protein product. -

Breast-ovarian cancer, familial, susceptibility to, 2 Pathogenic:2
Oct 02, 2015
Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA), c/o University of Cambridge
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Feb 28, 2015
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Hereditary cancer-predisposing syndrome Pathogenic:2
Mar 07, 2022
Color Diagnostics, LLC DBA Color Health
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant causes a G to A nucleotide substitution at the +1 position of intron 21 of the BRCA2 gene. This variant is also known as IVS21+1G>A based on Breast Cancer Information Core (BIC) nomenclature. An RNA study has shown that this variant results in the use of a cryptic splice site in intron 21, and is expected to create a premature stop codon and result in an absent or non-functional protein product (PMID: 18597679). This variant has been reported in individuals affected with breast and ovarian cancer, and described as de novo in an individual affected with early onset breast cancer (PMID: 18597679, 28947987; Color internal data). This variant has been identified in one family among the CIMBA participants (PMID: 29446198) (https://cimba.ccge.medschl.cam.ac.uk/). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Loss of BRCA2 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -

Jul 10, 2024
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The c.8754+1G>A intronic pathogenic mutation results from a G to A substitution one nucleotide after coding exon 20 of the BRCA2 gene. This alteration was identified in a Danish patient diagnosed with breast cancer at 40. Functional analysis and RNA studies indicated abolishment of the native donor site and activation of a cryptic splice site 46 base pairs downstream in coding intron 20, resulting in a premature stop codon and truncated protein (Ambry internal data; Hansen TV et al. BMC Med. Genet. 2008;9:58). This alteration is reported to be an Austrian founder mutation (Janaviius R EPMA J 2010 Sep;1(3):397-412), but has also been identified in individuals from other countries (Solano AR et al. Oncotarget 2017 Sep;8(36):60487-60495). This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). In addition to the clinical data presented in the literature, alterations that disrupt the canonical splice site are expected to cause aberrant splicing, resulting in an abnormal protein or a transcript that is subject to nonsense-mediated mRNA decay. As such, this alteration is classified as a disease-causing mutation. -

not provided Pathogenic:1
Dec 15, 2022
Revvity Omics, Revvity
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Malignant tumor of breast Pathogenic:1
-
Department of Pathology and Laboratory Medicine, Sinai Health System
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

The BRCA2 c.8754+1G>A was first identified as a de novo mutation in a Danish breast cancer patient, and through minigene splicing assays was found to produce a transcript containing an additional 46 bp from intron 21 (confirmed by whole blood RNA based RT-PCR/sequencing), that resulted in a truncated BRCA2 protein (Hansen 2008). The variant was also later identified in 1 of 1880 proband chromosomes (frequency: 0.001) from Argentinian individuals or families with familial and/or personal history of breast/ovarian cancer (Solano 2016). The variant was also identified in dbSNP (ID: rs397508006) as “With Pathogenic allele”, Clinvitae database (classification pathogenic), and ARUP Laboratories BRCA Mutations Database (classification definitely pathogenic), the ClinVar database (classification pathogenic by Quest Diagnostics Nichols Institute San Juan Capistrano and the Consortium of Investigators of Modifiers of BRCA1/2 c/o University of Cambridge, and by Invitae (classification not provided)); it was not identified in GeneInsight COGR database, UMD, Fanconi Anemia Mutation Database (LOVD), LOVD-IARC database, COSMIC, 1000 Genomes Project, NHLBI GO Exome Sequencing Project, and the Exome Aggregation Consortium database (August 8, 2016). The c.8754+1G>A variant is predicted to cause abnormal splicing because the nucleotide substitution occurs in the invariant region of the splice consensus sequence. In addition, 5 of 5 in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer, HumanSpliceFinder) predict a greater than 10% difference in splicing, correlating with the above published findings. In summary, based on the above information, this variant meets our laboratory’s criteria to be classified as pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Pathogenic
0.44
D
BayesDel_noAF
Pathogenic
0.39
CADD
Pathogenic
35
DANN
Uncertain
1.0
Eigen
Pathogenic
1.1
Eigen_PC
Pathogenic
0.99
FATHMM_MKL
Pathogenic
0.99
D
GERP RS
5.3

Splicing

Name
Calibrated prediction
Score
Prediction
dbscSNV1_ADA
Pathogenic
1.0
dbscSNV1_RF
Pathogenic
0.94
SpliceAI score (max)
0.99
Details are displayed if max score is > 0.2
DS_DG_spliceai
0.76
Position offset: 45
DS_DL_spliceai
0.99
Position offset: -1

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: rs397508006; hg19: chr13-32950929; API