rs863224465

Variant summary

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

The NM_000059.4(BRCA2):​c.4936_4939delGAAA​(p.Glu1646GlnfsTer23) variant causes a frameshift change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000206 in 1,454,568 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★★). Variant results in nonsense mediated mRNA decay.

Frequency

Genomes: not found (cov: 32)
Exomes 𝑓: 0.0000021 ( 0 hom. )

Consequence

BRCA2
NM_000059.4 frameshift

Scores

Not classified

Clinical Significance

Pathogenic reviewed by expert panel P:25

Conservation

PhyloP100: 1.07
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
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 13-32339287-AAAAG-A is Pathogenic according to our data. Variant chr13-32339287-AAAAG-A is described in ClinVar as [Pathogenic]. Clinvar id is 37935.Status of the report is reviewed_by_expert_panel, 3 stars. Variant chr13-32339287-AAAAG-A is described in Lovd as [Pathogenic]. Variant chr13-32339287-AAAAG-A is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
BRCA2NM_000059.4 linkc.4936_4939delGAAA p.Glu1646GlnfsTer23 frameshift_variant Exon 11 of 27 ENST00000380152.8 NP_000050.3 P51587

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
BRCA2ENST00000380152.8 linkc.4936_4939delGAAA p.Glu1646GlnfsTer23 frameshift_variant Exon 11 of 27 5 NM_000059.4 ENSP00000369497.3 P51587
BRCA2ENST00000530893.7 linkc.4567_4570delGAAA p.Glu1523GlnfsTer23 frameshift_variant Exon 11 of 27 1 ENSP00000499438.2 A0A590UJI7
BRCA2ENST00000614259.2 linkn.4936_4939delGAAA non_coding_transcript_exon_variant Exon 10 of 26 2 ENSP00000506251.1 A0A7P0TAP7

Frequencies

GnomAD3 genomes
Cov.:
32
GnomAD4 exome
AF:
0.00000206
AC:
3
AN:
1454568
Hom.:
0
AF XY:
0.00000277
AC XY:
2
AN XY:
723264
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.0000464
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
9.01e-7
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
Cov.:
32
Bravo
AF:
0.0000113

ClinVar

Significance: Pathogenic
Submissions summary: Pathogenic:25
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Breast-ovarian cancer, familial, susceptibility to, 2 Pathogenic:7
Sep 08, 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. -

Dec 17, 2012
Sharing Clinical Reports Project (SCRP)
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Sep 23, 2016
Department of Medical Genetics, Oslo University Hospital
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

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

- -

Nov 23, 2015
Counsyl
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

May 29, 2002
Breast Cancer Information Core (BIC) (BRCA2)
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Oct 23, 2023
All of Us Research Program, National Institutes of Health
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant deletes 4 nucleotides in exon 11 of the BRCA2 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 been reported in at least 10 heterozygous individuals affected with breast and ovarian cancer (PMID: 16030099, 17020472, 20104584, 21553119, 23479189, 26026974, 28503720, 29084914, 29560538, 33471991; Leiden Open Variation Database DB-ID BRCA2_001062, 34290354, 34645131, 34933735, Color internal data) and 3 individuals affected with pancreatic cancer (PMID: 30274973, Color internal data). This variant also has been observed in compound heterozygous state with a known pathogenic BRCA2 mutation in individuals affected with the recessive disease, Fanconi anemia (PMID: 15070707). 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. -

not provided Pathogenic:7
Jun 02, 2017
Eurofins Ntd Llc (ga)
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Feb 15, 2022
Revvity Omics, Revvity
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Nov 29, 2019
GeneDx
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

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; Observed with a pathogenic BRCA2 variant on the opposite allele (in trans) in siblings with Fanconi anemia (Wagner 2004); Not observed in large population cohorts (Lek 2016); Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; Observed in individuals with BRCA2-related cancers (Kaufman 2006, Stegel 2011, Novakovic 2012, de Juan Jimenez 2013, de Juan 2015, Hoberg-Vetti 2015, Bunnell 2016, Bannon 2018); Also known as c.5164del4; This variant is associated with the following publications: (PMID: 24301060, 22430266, 27276934, 28127413, 30274973, 30293905, 21232165, 23479189, 15070707, 22923021, 26350514, 15689453, 26026974, 26656232, 20104584, 26681312, 16758124, 20033483, 16825431, 17020472, 27741520, 27160020, 28503720, 28637432, 29560538, 28477318, 29084914, 28152038, 29086229, 30014164, 30755392, 30720863, 30322717, 31159747) -

Jun 09, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The BRCA2 c.4936_4939delGAAA; p.Glu1646GlnfsTer23 variant (rs80359473, also known as 5164del4), is reported in the literature in multiple individuals affected with hereditary breast and ovarian cancer and Fanconi anemia (de Juan 2015, de Juan Jimenez 2013, Esteban Cardenosa 2010, Gabaldo Barrios 2017, Infante 2006, Labidi-Galy 2018, Rummel 2017, Schayek 2018, Wagner 2004). This variant is reported as pathogenic by multiple laboratories in ClinVar (Variation ID: 37935) and is absent from the Genome Aggregation Database, indicating it is not a common polymorphism. This variant causes a frameshift by deleting 4 nucleotides, so it is predicted to result in a truncated protein or mRNA subject to nonsense-mediated decay. Based on available information, this variant is considered to be pathogenic. References: de Juan I et al. BRCA1 and BRCA2 mutations in males with familial breast and ovarian cancer syndrome. Results of a Spanish multicenter study. Fam Cancer. 2015 Dec;14(4):505-13. de Juan Jimenez I et al. Novel and recurrent BRCA1/BRCA2 mutations in early onset and familial breast and ovarian cancer detected in the Program of Genetic Counseling in Cancer of Valencian Community (eastern Spain). Relationship of family phenotypes with mutation prevalence. Fam Cancer. 2013 Dec;12(4):767-77. Esteban Cardenosa E et al. Broad BRCA1 and BRCA2 mutational spectrum and high incidence of recurrent and novel mutations in the eastern Spain population. Breast Cancer Res Treat. 2010 May;121(1):257-60. Gabaldo Barrios X et al. Molecular characterization and clinical interpretation of BRCA1/BRCA2 variants in families from Murcia (south-eastern Spain) with hereditary breast and ovarian cancer: clinical-pathological features in BRCA carriers and non-carriers. Fam Cancer. 2017 Oct;16(4):477-489. Infante M et al. High proportion of novel mutations of BRCA1 and BRCA2 in breast/ovarian cancer patients from Castilla-León (central Spain). J Hum Genet. 2006;51(7):611-7. Labidi-Galy SI et al. Location of Mutation in BRCA2 Gene and Survival in Patients with Ovarian Cancer. Clin Cancer Res. 2018 Jan 15;24(2):326-333. Rummel SK et al. Contribution of germline mutations in cancer predisposition genes to tumor etiology in young women diagnosed with invasive breast cancer. Breast Cancer Res Treat. 2017 Aug;164(3):593-601. Schayek H et al. Mutational analysis of candidate genes in Israeli male breast cancer cases. Breast Cancer Res Treat. 2018 Jul;170(2):399-404. Wagner JE et al. Germline mutations in BRCA2: shared genetic susceptibility to breast cancer, early onset leukemia, and Fanconi anemia. Blood. 2004 Apr 15;103(8):3226-9. -

Nov 19, 2018
Center for Personalized Medicine, Children's Hospital Los Angeles
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Apr 01, 2021
Quest Diagnostics Nichols Institute San Juan Capistrano
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This frameshift variant causes the premature termination of BRCA2 protein synthesis. In addition, it has been reported in breast, ovarian, male breast and pancreatic cancer in the published literature (PMID: 30274973 (2018), 26026974 (2015), 22923021 (2012), 21232165 (2011), 17020472 (2006), 16030099 (2005)). This variant has also been reported in Fanconi Anemia patients (PMID: 15070707 (2004)). Based on the available information, this variant is classified as pathogenic. -

Jan 31, 2017
Mayo Clinic Laboratories, Mayo Clinic
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Hereditary breast ovarian cancer syndrome Pathogenic:5
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

- -

Aug 15, 2016
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The p.Glu1646fs variant in BRCA2 has been reported as heterozygous in >20 indivi duals with BRCA2-associated cancers and as compound heterozygous in 2 siblings w ith Fanconi anemia (H?berg-Vetti 2016, Jimenez 2013, Stegel 2011, Wagner 2004, B reast Cancer Information Core (BIC) database). It was absent from large populati on studies, though the ability of these studies to accurately detect indels may be limited. This variant is predicted to cause a frameshift, which alters the pr otein?s amino acid sequence beginning at position 1646 and leads to a premature termination codon 23 amino acids downstream. This alteration is then predicted t o lead to a truncated or absent protein. Heterozygous loss of function of the BR CA2 gene is an established disease mechanism in individuals with hereditary brea st and ovarian cancer (HBOC). In addition, this variant was classified as Pathog enic on September 8, 2016 by the ClinGen-approved ENIGMA expert panel (ClinVar S CV000300803.2). In summary, this variant meets our criteria to be classified as pathogenic for HBOC in an autosomal dominant manner . -

Jan 09, 2021
GeneKor MSA
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change deletes 4 bases from exon 11 of the BRCA2 mRNA (c.4936_4939delGAAA), causing a frameshift after codon 1646. This creates a premature translational stop signal 23 amino acid residues later (p.(Glu1646Glnfs*23) and is expected to result in an absent or disrupted protein product. Truncating variants in BRCA2 are known to be pathogenic. This particular variant is also known in the literature as c.4933_4936delAAAG and 5164del4 and has been described in the literature in families with breast and/or ovarian cancer and Fanconi anemia (PMID: 23479189, 22923021, 15070707,31159747). The mutation database Clinvar contains entries for this variant (Variation ID:37935). -

Jan 17, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change creates a premature translational stop signal (p.Glu1646Glnfs*23) in the BRCA2 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in BRCA2 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 Fanconi anemia (PMID: 15070707, 20960228, 22923021, 23479189, 26350514). This variant is also known as c.4933_4936delAAAG and 5164del4. ClinVar contains an entry for this variant (Variation ID: 37935). For these reasons, this variant has been classified as Pathogenic. -

Jan 03, 2019
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.4936_4939delGAAA (p.Glu1646GlnfsX23) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. The variant was absent in 238878 control chromosomes (gnomAD). c.4936_4939delGAAA has been reported in the literature in multiple individuals affected with Hereditary Breast and Ovarian Cancer (Finkelman_2012, Infante_2006, Kaufman_2006, Krajc_2008, Borg_2010, Beristain_2010, de Juan Jimenez_2012, Novakovic_2012). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Fourteen ClinVar submissions from other clinical diagnostic laboratories (evaluation after 2014) cite the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -

Hereditary cancer-predisposing syndrome Pathogenic:4
Apr 26, 2023
Color Diagnostics, LLC DBA Color Health
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This variant deletes 4 nucleotides in exon 11 of the BRCA2 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 been reported in at least 10 heterozygous individuals affected with breast and ovarian cancer (PMID: 16030099, 17020472, 20104584, 21553119, 23479189, 26026974, 28503720, 29084914, 29560538, 33471991; Leiden Open Variation Database DB-ID BRCA2_001062, 34290354, 34645131, 34933735, Color internal data) and 3 individuals affected with pancreatic cancer (PMID: 30274973, Color internal data). This variant also has been observed in compound heterozygous state with a known pathogenic BRCA2 mutation in individuals affected with the recessive disease, Fanconi anemia (PMID: 15070707). 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. -

Aug 05, 2021
Sema4, Sema4
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: curation

- -

Jan 27, 2023
Ambry Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

The c.4936_4939delGAAA (p.E1646Qfs*23) alteration, located in exon 11 (coding exon 10) of the BRCA2 gene, consists of a deletion of 4 nucleotides from position 4936 to 4939, causing a translational frameshift with a predicted alternate stop codon after 23 amino acids. This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. This variant was not reported in population-based cohorts in the Genome Aggregation Database (gnomAD). This mutation has been reported in multiple hereditary breast and ovarian cancer (HBOC) syndrome families (Weitzel, 2005; Kaufman, 2006; Infante, 2006; Borg, 2010; Stegel, 2011; Laitman, 2011; De Leeneer, 2012; Novakovi, 2012; de Juan Jiménez, 2013; Høberg-Vetti, 2016; Gabaldó Barrios, 2017; Bunnell, 2017; Baert, 2017; Rummel, 2017; Carter, 2018; Labidi-Galy, 2018; Deng, 2019; Palmer, 2020; Breast Cancer Association, 2021). This mutation has also been reported in a patient with early-onset pancreatic cancer (Bannon, 2018), as well as a male patient with transitional cell carcinoma (Kinget, 2021). Of note, this alteration is also designated as 5164del4, c.5164_5167del, and c.5164_5167delGAAA in published literature. Based on the available evidence, this alteration is classified as pathogenic. -

Sep 11, 2017
True Health Diagnostics
Significance: Pathogenic
Review Status: no assertion criteria provided
Collection Method: clinical testing

- -

Breast-ovarian cancer, familial, susceptibility to, 1 Pathogenic:1
Apr 02, 2020
Department of Molecular Diagnostics, Institute of Oncology Ljubljana
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Familial cancer of breast Pathogenic:1
Mar 30, 2024
Baylor Genetics
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

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: rs80359473; hg19: chr13-32913424; API