Abstract
INTRODUCTION—A small fraction of breast cancer is the result of germline mutations in the BRCA1 and BRCA2 cancer susceptibility genes. Mutation carriers frequently have a positive family history of breast and ovarian cancer, are often diagnosed at a young age, and may have a higher incidence of double or multiple primary breast tumours than breast cancer patients in general. OBJECTIVES—To estimate the prevalence and spectrum of BRCA1 and BRCA2 mutations in young Danish patients affected with bilateral or multifocal breast cancer and to determine the relationship of mutation status to family history of cancer. SUBJECTS—From the files of the Danish Breast Cancer Cooperative Group (DBCG), we selected 119 breast cancer patients diagnosed before the age of 46 years with either bilateral (n=59) or multifocal (n=61) disease. METHODS—DNA from the subjects was screened for BRCA1 and BRCA2 mutations using single strand conformation analysis (SSCA) and the protein truncation test (PTT). Observed and expected cancer incidence in first degree relatives of the patients was estimated using data from the Danish Cancer Registry. RESULTS—Twenty four mutation carriers were identified (20%), of whom 13 had a BRCA1 mutation and 11 carried a BRCA2 mutation. Two mutations in BRCA1 were found repeatedly in the material and accounted for seven of the 24 (29%) mutation carriers. The mutation frequency was about equal in patients with bilateral (22%) and multifocal breast cancer (18%). The incidence of breast and ovarian cancer was greatly increased in first degree relatives of BRCA1 and BRCA2 mutation carriers, but to a much lesser degree in relatives of non-carriers. An increased risk of cancer was also noted in brothers of non-carriers. CONCLUSIONS—A relatively broad spectrum of germline mutations was observed in BRCA1 and BRCA2 and most of the mutations are present in other populations. Our results indicate that a diagnosis of bilateral and multifocal breast cancer is predictive of BRCA1 and BRCA2 mutation status, particularly when combined with information on the patients' age at diagnosis and family history of breast/ovarian cancer. Keywords: breast cancer; mutations; BRCA1; BRCA2
Full Text
The Full Text of this article is available as a PDF (198.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adami H. O., Bergström R., Hansen J. Age at first primary as a determinant of the incidence of bilateral breast cancer. Cumulative and relative risks in a population-based case-control study. Cancer. 1985 Feb 1;55(3):643–647. doi: 10.1002/1097-0142(19850201)55:3<643::aid-cncr2820550328>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
- Anastassiades O., Iakovou E., Stavridou N., Gogas J., Karameris A. Multicentricity in breast cancer. A study of 366 cases. Am J Clin Pathol. 1993 Mar;99(3):238–243. doi: 10.1093/ajcp/99.3.238. [DOI] [PubMed] [Google Scholar]
- Couch F. J., Farid L. M., DeShano M. L., Tavtigian S. V., Calzone K., Campeau L., Peng Y., Bogden B., Chen Q., Neuhausen S. BRCA2 germline mutations in male breast cancer cases and breast cancer families. Nat Genet. 1996 May;13(1):123–125. doi: 10.1038/ng0596-123. [DOI] [PubMed] [Google Scholar]
- Durocher F., Shattuck-Eidens D., McClure M., Labrie F., Skolnick M. H., Goldgar D. E., Simard J. Comparison of BRCA1 polymorphisms, rare sequence variants and/or missense mutations in unaffected and breast/ovarian cancer populations. Hum Mol Genet. 1996 Jun;5(6):835–842. doi: 10.1093/hmg/5.6.835. [DOI] [PubMed] [Google Scholar]
- Ford D., Easton D. F., Stratton M., Narod S., Goldgar D., Devilee P., Bishop D. T., Weber B., Lenoir G., Chang-Claude J. Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. The Breast Cancer Linkage Consortium. Am J Hum Genet. 1998 Mar;62(3):676–689. doi: 10.1086/301749. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Friend S., Borresen A. L., Brody L., Casey G., Devilee P., Gayther S., Goldgar D., Murphy P., Weber B. L., Wiseman R. Breast cancer information on the web. Nat Genet. 1995 Nov;11(3):238–239. doi: 10.1038/ng1195-238. [DOI] [PubMed] [Google Scholar]
- Gayther S. A., Mangion J., Russell P., Seal S., Barfoot R., Ponder B. A., Stratton M. R., Easton D. Variation of risks of breast and ovarian cancer associated with different germline mutations of the BRCA2 gene. Nat Genet. 1997 Jan;15(1):103–105. doi: 10.1038/ng0197-103. [DOI] [PubMed] [Google Scholar]
- Gayther S. A., Warren W., Mazoyer S., Russell P. A., Harrington P. A., Chiano M., Seal S., Hamoudi R., van Rensburg E. J., Dunning A. M. Germline mutations of the BRCA1 gene in breast and ovarian cancer families provide evidence for a genotype-phenotype correlation. Nat Genet. 1995 Dec;11(4):428–433. doi: 10.1038/ng1295-428. [DOI] [PubMed] [Google Scholar]
- Gershoni-Baruch R., Dagan E., Fried G., Kepten I., Robinson E. BRCA1 and BRCA2 founder mutations in patients with bilateral breast cancer. Eur J Hum Genet. 1999 Oct-Nov;7(7):833–836. doi: 10.1038/sj.ejhg.5200371. [DOI] [PubMed] [Google Scholar]
- Goggins M., Schutte M., Lu J., Moskaluk C. A., Weinstein C. L., Petersen G. M., Yeo C. J., Jackson C. E., Lynch H. T., Hruban R. H. Germline BRCA2 gene mutations in patients with apparently sporadic pancreatic carcinomas. Cancer Res. 1996 Dec 1;56(23):5360–5364. [PubMed] [Google Scholar]
- Håkansson S., Johannsson O., Johansson U., Sellberg G., Loman N., Gerdes A. M., Holmberg E., Dahl N., Pandis N., Kristoffersson U. Moderate frequency of BRCA1 and BRCA2 germ-line mutations in Scandinavian familial breast cancer. Am J Hum Genet. 1997 May;60(5):1068–1078. [PMC free article] [PubMed] [Google Scholar]
- Jensen D. E., Proctor M., Marquis S. T., Gardner H. P., Ha S. I., Chodosh L. A., Ishov A. M., Tommerup N., Vissing H., Sekido Y. BAP1: a novel ubiquitin hydrolase which binds to the BRCA1 RING finger and enhances BRCA1-mediated cell growth suppression. Oncogene. 1998 Mar 5;16(9):1097–1112. doi: 10.1038/sj.onc.1201861. [DOI] [PubMed] [Google Scholar]
- Lancaster J. M., Carney M. E., Gray J., Myring J., Gumbs C., Sampson J., Wheeler D., France E., Wiseman R., Harper P. BRCA1 and BRCA2 in breast cancer families from Wales: moderate mutation frequency and two recurrent mutations in BRCA1. Br J Cancer. 1998 Dec;78(11):1417–1420. doi: 10.1038/bjc.1998.701. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lesser M. L., Rosen P. P., Kinne D. W. Multicentricity and bilaterality in invasive breast carcinoma. Surgery. 1982 Feb;91(2):234–240. [PubMed] [Google Scholar]
- Malone K. E., Daling J. R., Thompson J. D., O'Brien C. A., Francisco L. V., Ostrander E. A. BRCA1 mutations and breast cancer in the general population: analyses in women before age 35 years and in women before age 45 years with first-degree family history. JAMA. 1998 Mar 25;279(12):922–929. doi: 10.1001/jama.279.12.922. [DOI] [PubMed] [Google Scholar]
- Mazoyer S., Dunning A. M., Serova O., Dearden J., Puget N., Healey C. S., Gayther S. A., Mangion J., Stratton M. R., Lynch H. T. A polymorphic stop codon in BRCA2. Nat Genet. 1996 Nov;14(3):253–254. doi: 10.1038/ng1196-253. [DOI] [PubMed] [Google Scholar]
- Miki Y., Swensen J., Shattuck-Eidens D., Futreal P. A., Harshman K., Tavtigian S., Liu Q., Cochran C., Bennett L. M., Ding W. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science. 1994 Oct 7;266(5182):66–71. doi: 10.1126/science.7545954. [DOI] [PubMed] [Google Scholar]
- Milner J., Ponder B., Hughes-Davies L., Seltmann M., Kouzarides T. Transcriptional activation functions in BRCA2. Nature. 1997 Apr 24;386(6627):772–773. doi: 10.1038/386772a0. [DOI] [PubMed] [Google Scholar]
- Monteiro A. N., August A., Hanafusa H. Evidence for a transcriptional activation function of BRCA1 C-terminal region. Proc Natl Acad Sci U S A. 1996 Nov 26;93(24):13595–13599. doi: 10.1073/pnas.93.24.13595. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Olsen J. H., Seersholm N., Boice J. D., Jr, Krüger Kjaer S., Fraumeni J. F., Jr Cancer risk in close relatives of women with early-onset breast cancer--a population-based incidence study. Br J Cancer. 1999 Feb;79(3-4):673–679. doi: 10.1038/sj.bjc.6690106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Peto J., Collins N., Barfoot R., Seal S., Warren W., Rahman N., Easton D. F., Evans C., Deacon J., Stratton M. R. Prevalence of BRCA1 and BRCA2 gene mutations in patients with early-onset breast cancer. J Natl Cancer Inst. 1999 Jun 2;91(11):943–949. doi: 10.1093/jnci/91.11.943. [DOI] [PubMed] [Google Scholar]
- Petrij-Bosch A., Peelen T., van Vliet M., van Eijk R., Olmer R., Drüsedau M., Hogervorst F. B., Hageman S., Arts P. J., Ligtenberg M. J. BRCA1 genomic deletions are major founder mutations in Dutch breast cancer patients. Nat Genet. 1997 Nov;17(3):341–345. doi: 10.1038/ng1197-341. [DOI] [PubMed] [Google Scholar]
- Phelan C. M., Rebbeck T. R., Weber B. L., Devilee P., Ruttledge M. H., Lynch H. T., Lenoir G. M., Stratton M. R., Easton D. F., Ponder B. A. Ovarian cancer risk in BRCA1 carriers is modified by the HRAS1 variable number of tandem repeat (VNTR) locus. Nat Genet. 1996 Mar;12(3):309–311. doi: 10.1038/ng0396-309. [DOI] [PubMed] [Google Scholar]
- Sobczak K., Kozłowski P., Napierała M., Czarny J., Woźniak M., Kapuścińska M., Lośko M., Koziczak M., Jasińska A., Powierska J. Novel BRCA1 mutations and more frequent intron-20 alteration found among 236 women from Western Poland. Oncogene. 1997 Oct 9;15(15):1773–1779. doi: 10.1038/sj.onc.1201360. [DOI] [PubMed] [Google Scholar]
- Stoppa-Lyonnet D., Laurent-Puig P., Essioux L., Pagès S., Ithier G., Ligot L., Fourquet A., Salmon R. J., Clough K. B., Pouillart P. BRCA1 sequence variations in 160 individuals referred to a breast/ovarian family cancer clinic. Institut Curie Breast Cancer Group. Am J Hum Genet. 1997 May;60(5):1021–1030. [PMC free article] [PubMed] [Google Scholar]
- Struewing J. P., Hartge P., Wacholder S., Baker S. M., Berlin M., McAdams M., Timmerman M. M., Brody L. C., Tucker M. A. The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med. 1997 May 15;336(20):1401–1408. doi: 10.1056/NEJM199705153362001. [DOI] [PubMed] [Google Scholar]
- Szabo C. I., King M. C. Population genetics of BRCA1 and BRCA2. Am J Hum Genet. 1997 May;60(5):1013–1020. [PMC free article] [PubMed] [Google Scholar]
- Szabo C. I., Wagner L. A., Francisco L. V., Roach J. C., Argonza R., King M. C., Ostrander E. A. Human, canine and murine BRCA1 genes: sequence comparison among species. Hum Mol Genet. 1996 Sep;5(9):1289–1298. doi: 10.1093/hmg/5.9.1289. [DOI] [PubMed] [Google Scholar]
- Thorlacius S., Struewing J. P., Hartge P., Olafsdottir G. H., Sigvaldason H., Tryggvadottir L., Wacholder S., Tulinius H., Eyfjörd J. E. Population-based study of risk of breast cancer in carriers of BRCA2 mutation. Lancet. 1998 Oct 24;352(9137):1337–1339. doi: 10.1016/s0140-6736(98)03300-5. [DOI] [PubMed] [Google Scholar]
- Tirkkonen M., Johannsson O., Agnarsson B. A., Olsson H., Ingvarsson S., Karhu R., Tanner M., Isola J., Barkardottir R. B., Borg A. Distinct somatic genetic changes associated with tumor progression in carriers of BRCA1 and BRCA2 germ-line mutations. Cancer Res. 1997 Apr 1;57(7):1222–1227. [PubMed] [Google Scholar]
- Welcsh P. L., Owens K. N., King M. C. Insights into the functions of BRCA1 and BRCA2. Trends Genet. 2000 Feb;16(2):69–74. doi: 10.1016/s0168-9525(99)01930-7. [DOI] [PubMed] [Google Scholar]
- Westman-Naeser S., Bengtsson E., Eriksson O., Jarkrans T., Nordin B., Stenkvist B. Multifocal breast carcinoma. Am J Surg. 1981 Aug;142(2):255–257. doi: 10.1016/0002-9610(81)90288-9. [DOI] [PubMed] [Google Scholar]
- Wooster R., Bignell G., Lancaster J., Swift S., Seal S., Mangion J., Collins N., Gregory S., Gumbs C., Micklem G. Identification of the breast cancer susceptibility gene BRCA2. Nature. 1995 Dec 21;378(6559):789–792. doi: 10.1038/378789a0. [DOI] [PubMed] [Google Scholar]
- Wu L. C., Wang Z. W., Tsan J. T., Spillman M. A., Phung A., Xu X. L., Yang M. C., Hwang L. Y., Bowcock A. M., Baer R. Identification of a RING protein that can interact in vivo with the BRCA1 gene product. Nat Genet. 1996 Dec;14(4):430–440. doi: 10.1038/ng1296-430. [DOI] [PubMed] [Google Scholar]