Investigating the effects of additional truncating variants in DNA-repair genes on breast cancer risk in BRCA1-positive women.


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
08 Aug 2019
Historique:
received: 16 05 2018
accepted: 16 07 2019
entrez: 10 8 2019
pubmed: 10 8 2019
medline: 10 1 2020
Statut: epublish

Résumé

Inherited pathogenic variants in BRCA1 and BRCA2 are the most common causes of hereditary breast and ovarian cancer (HBOC). The risk of developing breast cancer by age 80 in women carrying a BRCA1 pathogenic variant is 72%. The lifetime risk varies between families and even within affected individuals of the same family. The cause of this variability is largely unknown, but it is hypothesized that additional genetic factors contribute to differences in age at onset (AAO). Here we investigated whether truncating and rare missense variants in genes of different DNA-repair pathways contribute to this phenomenon. We used extreme phenotype sampling to recruit 133 BRCA1-positive patients with either early breast cancer onset, below 35 (early AAO cohort) or cancer-free by age 60 (controls). Next Generation Sequencing (NGS) was used to screen for variants in 311 genes involved in different DNA-repair pathways. Patients with an early AAO (73 women) had developed breast cancer at a median age of 27 years (interquartile range (IQR); 25.00-27.00 years). A total of 3703 variants were detected in all patients and 43 of those (1.2%) were truncating variants. The truncating variants were found in 26 women of the early AAO group (35.6%; 95%-CI 24.7 - 47.7%) compared to 16 women of controls (26.7%; 95%-CI 16.1 to 39.7%). When adjusted for environmental factors and family history, the odds ratio indicated an increased breast cancer risk for those carrying an additional truncating DNA-repair variant to BRCA1 mutation (OR: 3.1; 95%-CI 0.92 to 11.5; p-value = 0.07), although it did not reach the conventionally acceptable significance level of 0.05. To our knowledge this is the first time that the combined effect of truncating variants in DNA-repair genes on AAO in patients with hereditary breast cancer is investigated. Our results indicate that co-occurring truncating variants might be associated with an earlier onset of breast cancer in BRCA1-positive patients. Larger cohorts are needed to confirm these results.

Sections du résumé

BACKGROUND BACKGROUND
Inherited pathogenic variants in BRCA1 and BRCA2 are the most common causes of hereditary breast and ovarian cancer (HBOC). The risk of developing breast cancer by age 80 in women carrying a BRCA1 pathogenic variant is 72%. The lifetime risk varies between families and even within affected individuals of the same family. The cause of this variability is largely unknown, but it is hypothesized that additional genetic factors contribute to differences in age at onset (AAO). Here we investigated whether truncating and rare missense variants in genes of different DNA-repair pathways contribute to this phenomenon.
METHODS METHODS
We used extreme phenotype sampling to recruit 133 BRCA1-positive patients with either early breast cancer onset, below 35 (early AAO cohort) or cancer-free by age 60 (controls). Next Generation Sequencing (NGS) was used to screen for variants in 311 genes involved in different DNA-repair pathways.
RESULTS RESULTS
Patients with an early AAO (73 women) had developed breast cancer at a median age of 27 years (interquartile range (IQR); 25.00-27.00 years). A total of 3703 variants were detected in all patients and 43 of those (1.2%) were truncating variants. The truncating variants were found in 26 women of the early AAO group (35.6%; 95%-CI 24.7 - 47.7%) compared to 16 women of controls (26.7%; 95%-CI 16.1 to 39.7%). When adjusted for environmental factors and family history, the odds ratio indicated an increased breast cancer risk for those carrying an additional truncating DNA-repair variant to BRCA1 mutation (OR: 3.1; 95%-CI 0.92 to 11.5; p-value = 0.07), although it did not reach the conventionally acceptable significance level of 0.05.
CONCLUSIONS CONCLUSIONS
To our knowledge this is the first time that the combined effect of truncating variants in DNA-repair genes on AAO in patients with hereditary breast cancer is investigated. Our results indicate that co-occurring truncating variants might be associated with an earlier onset of breast cancer in BRCA1-positive patients. Larger cohorts are needed to confirm these results.

Identifiants

pubmed: 31395037
doi: 10.1186/s12885-019-5946-0
pii: 10.1186/s12885-019-5946-0
pmc: PMC6686546
doi:

Substances chimiques

BRCA1 Protein 0
BRCA1 protein, human 0
Biomarkers, Tumor 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

787

Subventions

Organisme : Fortüne Project grant of the Medical Faculty of the University of Tübingen
ID : Nr.2253-0-0

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Auteurs

Ilnaz Sepahi (I)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Ulrike Faust (U)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Marc Sturm (M)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Kristin Bosse (K)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Martin Kehrer (M)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Tilman Heinrich (T)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Kathrin Grundman-Hauser (K)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Peter Bauer (P)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.
CENTOGENE AG, Rostock, Germany.

Stephan Ossowski (S)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.
Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.

Hana Susak (H)

Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.

Raymonda Varon (R)

Institute of Medical and Human Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany.

Evelin Schröck (E)

Institute for Clinical Genetics, Dresden, Germany.

Dieter Niederacher (D)

Department of Obstetrics and Gynaecology, Düsseldorf University Hospital, Düsseldorf, Germany.

Bernd Auber (B)

Department of Human Genetics, Hannover Medical School, Hannover, Germany.

Christian Sutter (C)

Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany.

Norbert Arnold (N)

Department of Gynaecology and Obstetrics and Institute of Clinical Molecular Biology, University Hospital of Schleswig-Holstein, Christian-Albrechts-University of Kiel, Kiel, Germany.

Eric Hahnen (E)

Centre for Hereditary Breast and Ovarian Cancer, University of Cologne and University Hospital Cologne, Cologne, Germany.

Bernd Dworniczak (B)

Institute of Human Genetics, University Hospital Münster, Münster, Germany.

Shan Wang-Gorke (S)

Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany.

Andrea Gehrig (A)

Centre of Familial Breast and Ovarian Cancer, Department of Medical Genetics, Institute of Human Genetics, University Würzburg, Würzburg, Germany.

Bernhard H F Weber (BHF)

Institute of Human Genetics, University of Regensburg, Regensburg, Germany.

Christoph Engel (C)

Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.

Johannes R Lemke (JR)

Institute of Human Genetics, University of Leipzig Hospitals and Clinics, Leipzig, Germany.

Andreas Hartkopf (A)

Department of Obstetrics and Gynecology, University of Tuebingen, Tuebingen, Germany.

Huu Phuc Nguyen (HP)

Department of Human Genetics, Ruhr-University Bochum, Bochum, Germany.

Olaf Riess (O)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.

Christopher Schroeder (C)

Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany. Christopher.Schroeder@med.uni-tuebingen.de.

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