Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_007294.4(BRCA1):c.2019delA(p.Glu673AspfsTer28) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. 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. E673E) has been classified as Likely 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 17-43093511-GT-G is Pathogenic according to our data. Variant chr17-43093511-GT-G is described in ClinVar as [Pathogenic]. Clinvar id is 54438.Status of the report is reviewed_by_expert_panel, 3 stars. Variant chr17-43093511-GT-G is described in Lovd as [Pathogenic]. Variant chr17-43093511-GT-G is described in Lovd as [Pathogenic].
Breast-ovarian cancer, familial, susceptibility to, 1 Pathogenic:9
Mar 04, 2008
Sharing Clinical Reports Project (SCRP)
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing
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Mar 02, 2011
Breast Cancer Information Core (BIC) (BRCA1)
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing
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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
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Apr 22, 2016
Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA)
Significance: Pathogenic
Review Status: reviewed by expert panel
Collection Method: curation
Variant allele predicted to encode a truncated non-functional protein. -
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Medical Genetics, Medical University Pleven
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research
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Mar 02, 2020
BRCAlab, Lund University
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing
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Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing
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Sep 21, 2015
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
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Jul 01, 2015
Department of Medical Genetics, Oslo University Hospital
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
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not provided Pathogenic:4
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Clinical Genetics Laboratory, Department of Pathology, Netherlands Cancer Institute
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing
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Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing
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Sep 05, 2017
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
This deletion of one nucleotide in BRCA1 is denoted c.2019delA at the cDNA level and p.Glu673AspfsX28 (E673DfsX28) at the protein level. Using alternate nomenclature, this variant has previously been published as BRCA1 2138delA and 2137delA. The normal sequence, with the base that is deleted in braces, is AAGA[A]CCTG. The deletion causes a frameshift which changes a Glutamic Acid to an Aspartic Acid at codon 673, and creates a premature stop codon at position 28 of the new reading frame. This variant is predicted to cause loss of normal protein function through either protein truncation or nonsense-mediated mRNA decay. BRCA1 c.2019delA has been reported in multiple individuals with personal and/or family histories of breast and ovarian cancer and is a common pathogenic variant in the Dutch population (Yazici 2002, Szabo 2004, Hermsen 2006, Jacobi 2007, Dobricic 2013, Brohet 2014). We consider this variant to be pathogenic. -
Dec 20, 2022
Clinical Genetics Laboratory, Skane University Hospital Lund
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
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Hereditary breast ovarian cancer syndrome Pathogenic:3
Dec 07, 2021
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
For these reasons, this variant has been classified as Pathogenic. ClinVar contains an entry for this variant (Variation ID: 54438). This variant is also known as 2137delA and 2138delA. This premature translational stop signal has been observed in individual(s) with breast and ovarian cancer (PMID: 12112655, 14871810, 16683254, 23635950, 24307375). It is commonly reported in individuals of Dutch ancestry (PMID: 16683254, 24307375). This variant is not present in population databases (gnomAD no frequency). This sequence change creates a premature translational stop signal (p.Glu673Aspfs*28) 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). -
Jan 31, 2014
Research Molecular Genetics Laboratory, Women's College Hospital, University of Toronto
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: research
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Oct 13, 2016
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
Variant summary: The BRCA1 c.2019delA (p.Glu673Aspfs) variant results in a premature termination codon, predicted to cause a truncated or absent BRCA1 protein due to nonsense mediated decay (NMD), which are commonly known mechanisms for disease. If the variant escapes NMD, it is predicted to truncate BCRT domain (InterPro, UniProt). Truncations downstream of this position have been classified as pathogenic by our laboratory (e.g. p.Gln1135X, p.Gln1200X, p.Glu1250X, etc.). This variant is absent from 121362 control chromosomes from ExAC. This variant has been reported in multiple affected HBOC patients/families in literature and clinical databases. In addition, multiple clinical diagnostic laboratories/reputable databases have classified this variant as pathogenic. Taken together, this variant is classified as Pathogenic. -
Review Status: criteria provided, single submitter
Collection Method: clinical testing
This variant deletes 1 nucleotide in exon 10 of the BRCA1 gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. 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. -
Dec 09, 2022
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing
The c.2019delA pathogenic mutation, located in coding exon 9 of the BRCA1 gene, results from a deletion of one nucleotide at nucleotide position 2019, causing a translational frameshift with a predicted alternate stop codon (p.E673Dfs*28). This deletion has been reported in numerous high risk breast and/or ovarian cancer families (Yazici H, Hum. Mutat. 2002 Jul; 20(1):28-34, van der Hout AH, Hum. Mutat. 2006 Jul; 27(7):654-66, Dobrii J, J. Hum. Genet. 2013 Aug; 58(8):501-7; Jacobi CE et al. Genet. Med. 2007 Mar;9(3):173-9; Hermsen BB et al. Int. J. Cancer 2006 Sep;119(6):1412-8; Dacheva D et al. Mol Diagn Ther 2015 Apr;19(2):119-30). Of note, this alteration is also designated as 2137delA and 2138delA in published literature. 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. -