Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_007294.4(BRCA1):c.4251_4252del(p.Leu1418ArgfsTer9) 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 (★★★). 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 17-43082508-AAC-A is Pathogenic according to our data. Variant chr17-43082508-AAC-A is described in ClinVar as [Pathogenic]. Clinvar id is 37579.Status of the report is reviewed_by_expert_panel, 3 stars. Variant chr17-43082508-AAC-A is described in Lovd as [Pathogenic]. Variant chr17-43082508-AAC-A is described in Lovd as [Pathogenic].
The c.4251_4252delGT pathogenic mutation, located in coding exon 11 of the BRCA1 gene, results from a deletion of two nucleotides at nucleotide positions 4251 to 4252, causing a translational frameshift with a predicted alternate stop codon (p.L1418Rfs*9). This mutation, also referred to in the literature as 4370delGT, has been reported in a woman with bilateral breast cancer (Borg A et al. Hum. Mutat. 2010 Mar; 31(3)). 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. -
Pathogenic, criteria provided, single submitter
clinical testing
Color Diagnostics, LLC DBA Color Health
Jan 08, 2021
This variant deletes 2 nucleotides in exon 12 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. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in individuals and families affected with breast and ovarian cancer (PMID: 9150149, 20104584, 22762150, 28715532; UMD database). 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. -
not provided Pathogenic:1
Pathogenic, criteria provided, single submitter
clinical testing
GeneDx
Sep 03, 2022
Frameshift variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; Not observed at significant frequency in large population cohorts (gnomAD); Also known as 4370_4371del; This variant is associated with the following publications: (PMID: 9150149, 20104584, 28152038, 31853058) -
Familial cancer of breast Pathogenic:1
Pathogenic, no assertion criteria provided
clinical testing
Bioscientia Institut fuer Medizinische Diagnostik GmbH, Sonic Healthcare
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Hereditary breast ovarian cancer syndrome Pathogenic:1
Pathogenic, criteria provided, single submitter
clinical testing
Labcorp Genetics (formerly Invitae), Labcorp
Jan 28, 2024
This sequence change creates a premature translational stop signal (p.Leu1418Argfs*9) 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 breast cancer (PMID: 20104584). This variant is also known as 4370delGT. ClinVar contains an entry for this variant (Variation ID: 37579). For these reasons, this variant has been classified as Pathogenic. -