Our verdict is Likely pathogenic. Variant got 7 ACMG points: 7P and 0B. PM1PM2PP3_ModeratePP5
The NM_007294.4(BRCA1):c.4957G>T(p.Val1653Leu) variant causes a missense change. The variant allele was found at a frequency of 0.00000137 in 1,461,880 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 Conflicting classifications of pathogenicity (no stars).
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 7 ACMG points.
PM1
In a domain BRCT 1 (size 94) in uniprot entity BRCA1_HUMAN there are 74 pathogenic changes around while only 17 benign (81%) in NM_007294.4
PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.857
PP5
Variant 17-43070957-C-A is Pathogenic according to our data. Variant chr17-43070957-C-A is described in ClinVar as [Conflicting_classifications_of_pathogenicity]. Clinvar id is 868874.We mark this variant Likely_pathogenic, oryginal submissions are: {Likely_pathogenic=1, not_provided=1, Uncertain_significance=1}.
Hereditary breast ovarian cancer syndrome Pathogenic:1
Likely pathogenic, criteria provided, single submitter
clinical testing
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Apr 18, 2021
Variant summary: BRCA1 c.4957G>T (p.Val1653Leu) results in a conservative amino acid change located in the BRCT domain (IPR001357) of the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. However, a different substitution at the same codon, namely BRCA1, p.V1653M has been reported to impact BRCA1 function suggestive of the functional relevance of this residue. The variant was absent in 250924 control chromosomes. c.4957G>T has been reported in the literature in at-least three individuals of Japanese ancestry affected with Hereditary Breast And Ovarian Cancer Syndrome and at-least one reportedly unaffected Japanese woman control, although the possibility of breast cancer in this control subject cannot be ruled out (example, Hirotsu_2015, Nakagomi_2018, Momozawa_2018, Hirotsu_2020). These data indicate that the variant may be associated with disease. At least one publication reports experimental evidence evaluating an impact on protein function. The most pronounced variant effect results in loss of normal HDR activity (example Findlay_2018). In a cross sectional review of literature, this variant was initially classified as a "VUS" and has recently been re-classified as "Likely Pathogenic" citing the functional study utilized in the context of this evaluation (Hirotsu_2015, Hirotsu_2020, Findlay_2018). No clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014. Based on the evidence outlined above, the variant was classified as likely pathogenic. -
Uncertain significance, criteria provided, single submitter
clinical testing
Ambry Genetics
Jul 13, 2023
The p.V1653L variant (also known as c.4957G>T), located in coding exon 14 of the BRCA1 gene, results from a G to T substitution at nucleotide position 4957. The valine at codon 1653 is replaced by leucine, an amino acid with highly similar properties. This alteration was detected in a cohort of 135 Japanese breast and/or ovarian cancer patients (Hirotsu Y et al. Mol Genet Genomic Med, 2015 Mar;3:121-9). 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 Oct;562:217-222). 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. -
Breast-ovarian cancer, familial, susceptibility to, 1 Other:1