Differential Contributions of BRCA1 and BRCA2 to Early-Onset Breast Cancer
Michael Krainer, M.D., Sandra Silva-Arrieta, B.A., Michael G. FitzGerald, B.A., Akira Shimada, M.D., Chikashi Ishioka, M.D., Ryunosuke Kanamaru, M.D., Deborah J. MacDonald, R.N., M.S., Hilal Unsal, M.D., Dianne M. Finkelstein, Ph.D., Anne Bowcock, Ph.D., Kurt J. Isselbacher, M.D., and Daniel A. Haber, M.D., Ph.D.
Background Germ-line mutations in the BRCA1 and BRCA2 genespredispose women to breast cancer. BRCA1 mutations are foundin approximately 12 percent of women with breast cancer of earlyonset, and the specific mutation causing a deletion of adenineand guanine (185delAG), which is present in 1 percent of theAshkenazi Jewish population, contributes to 21 percent of breastcancers among young Jewish women. The contribution of BRCA2mutations to breast cancer of early onset is unknown.
Methods Lymphocyte specimens from 73 women with breast cancerdiagnosed by the age of 32 were studied for heterozygous mutationsof BRCA2 by a complementary-DNAbased protein-truncationassay, followed by automated nucleotide sequencing. In addition,specimens from 39 Jewish women with breast cancer diagnosedby the age of 40 were tested for specific mutations by an allele-specificpolymerase chain reaction.
Results Definite BRCA2 mutations were found in 2 of the 73 womenwith early-onset breast cancer (2.7 percent; 95 percent confidenceinterval, 0.4 to 9.6 percent), suggesting that BRCA2 is associatedwith fewer cases than BRCA1 (P = 0.03). The specific BRCA2 mutationcausing a deletion of thymine (6174delT), which is found in1.3 percent of the Ashkenazi Jewish population, was observedin 1 of the 39 young Jewish women with breast cancer (2.6 percent;95 percent confidence interval, 0.09 to 13.5 percent), indicatingthat it has a small role as a risk factor for early-onset breastcancer. Among young women with breast cancer, there are BRCA2mutations that cause truncation of the extreme C terminus ofthe protein and that may be functionally silent, along withdefinite truncating mutations.
Conclusions Germ-line mutations in BRCA2 contribute to fewercases of breast cancer among young women than do mutations inBRCA1. Carriers of BRCA2 mutations may have a smaller increasein the risk of early-onset breast cancer.
Source Information
From the Center for Cancer Risk Analysis and the Massachusetts General Hospital Cancer Center, Charlestown, Mass. (M.K., S.S.-A., M.G.F., D.J.M., H.U., K.J.I., D.A.H.); the Divisions of Biostatistics (D.M.F.) and HematologyOncology (D.A.H.), Massachusetts General Hospital and Harvard Medical School, Boston; the Department of Clinical Oncology, Tohoku University, Sendai, Japan (A.S., C.I., R.K.); and the Division of Pediatric HematologyOncology, University of Texas Southwestern Medical Center, Dallas (A.B.).
Address reprint requests to Dr. Haber at the Laboratory of Molecular Genetics, Massachusetts General Hospital Cancer Center, CNY 7, Bldg. 149, 13th St., Charlestown, MA 02129.
Stachelek, G. C., Dalal, S., Donigan, K. A., Campisi Hegan, D., Sweasy, J. B., Glazer, P. M.
(2010). Potentiation of Temozolomide Cytotoxicity by Inhibition of DNA Polymerase {beta} Is Accentuated by BRCA2 Mutation. Cancer Res.
70: 409-417
[Abstract][Full Text]
Sardanelli, F., Podo, F., D'Agnolo, G., Verdecchia, A., Santaquilani, M., Musumeci, R., Trecate, G., Manoukian, S., Morassut, S., de Giacomi, C., Federico, M., Cortesi, L., Corcione, S., Cirillo, S., Marra, V., For the High Breast Cancer Risk Italian Trial (HIB,
(2007). Multicenter Comparative Multimodality Surveillance of Women at Genetic-Familial High Risk for Breast Cancer (HIBCRIT Study): Interim Results. Radiology
242: 698-715
[Abstract][Full Text]
Simeone, A.-M., Deng, C.-X., Kelloff, G. J., Steele, V. E., Johnson, M. M., Tari, A. M.
(2005). N-(4-Hydroxyphenyl)retinamide is more potent than other phenylretinamides in inhibiting the growth of BRCA1-mutated breast cancer cells. Carcinogenesis
26: 1000-1007
[Abstract][Full Text]
Claus, E. B., Petruzella, S., Matloff, E., Carter, D.
(2005). Prevalence of BRCA1 and BRCA2 Mutations in Women Diagnosed With Ductal Carcinoma In Situ. JAMA
293: 964-969
[Abstract][Full Text]
Kim, S-W, Lee, C S, Fey, J V, Borgen, P I, Boyd, J
(2005). Prevalence of BRCA2 mutations in a hospital based series of unselected breast cancer cases. J. Med. Genet.
42: e5-e5
[Full Text]
Pal, T., Permuth-Wey, J., Holtje, T., Sutphen, R.
(2004). BRCA1 and BRCA2 Mutations in a Study of African American Breast Cancer Patients. Cancer Epidemiol. Biomarkers Prev.
13: 1794-1799
[Abstract][Full Text]
Evans, D G R, Eccles, D M, Rahman, N, Young, K, Bulman, M, Amir, E, Shenton, A, Howell, A, Lalloo, F
(2004). A new scoring system for the chances of identifying a BRCA1/2 mutation outperforms existing models including BRCAPRO. J. Med. Genet.
41: 474-480
[Abstract][Full Text]
Choi, D. H., Lee, M. H., Bale, A. E., Carter, D., Haffty, B. G.
(2004). Incidence of BRCA1 and BRCA2 Mutations in Young Korean Breast Cancer Patients. JCO
22: 1638-1645
[Abstract][Full Text]
Thull, D. L., Vogel, V. G.
(2004). Recognition and Management of Hereditary Breast Cancer Syndromes. The Oncologist
9: 13-24
[Abstract][Full Text]
Domchek, S. M., Eisen, A., Calzone, K., Stopfer, J., Blackwood, A., Weber, B. L.
(2003). Application of Breast Cancer Risk Prediction Models in Clinical Practice. JCO
21: 593-601
[Abstract][Full Text]
Scheuer, L., Kauff, N., Robson, M., Kelly, B., Barakat, R., Satagopan, J., Ellis, N., Hensley, M., Boyd, J., Borgen, P., Norton, L., Offit, K.
(2002). Outcome of Preventive Surgery and Screening for Breast and Ovarian Cancer in BRCA Mutation Carriers. JCO
20: 1260-1268
[Abstract][Full Text]
Martin, A.-M., Blackwood, M.A., Antin-Ozerkis, D., Shih, H.A., Calzone, K., Colligon, T.A., Seal, S., Collins, N., Stratton, M.R., Weber, B.L., Nathanson, K.L.
(2001). Germline Mutations in BRCA1 and BRCA2 in Breast-Ovarian Families From a Breast Cancer Risk Evaluation Clinic. JCO
19: 2247-2253
[Abstract][Full Text]
Chaudhuri, S., Cariappa, A., Tang, M., Bell, D., Haber, D. A., Isselbacher, K. J., Finkelstein, D., Forcione, D., Pillai, S.
(2000). Genetic susceptibility to breast cancer: HLA DQB*03032 and HLA DRB1*11 may represent protective alleles. Proc. Natl. Acad. Sci. USA
97: 11451-11454
[Abstract][Full Text]
PLASCHKE, J., COMMER, T., JACOBI, C., SCHACKERT, H. K, CHANG-CLAUDE, J.
(2000). BRCA2 germline mutations among early onset breast cancer patients unselected for family history of the disease. J. Med. Genet.
37: 17e-17
[Full Text]
Lehman, T. A., Haffty, B. G., Carbone, C. J., Bishop, L. R., Gumbs, A. A., Krishnan, S., Shields, P. G., Modali, R., Turner, B. C.
(2000). Elevated Frequency and Functional Activity of a Specific Germ-Line p53 Intron Mutation in Familial Breast Cancer. Cancer Res.
60: 1062-1069
[Abstract][Full Text]
Lal, G., Liu, G., Schmocker, B., Kaurah, P., Ozcelik, H., Narod, S. A., Redston, M., Gallinger, S.
(2000). Inherited Predisposition to Pancreatic Adenocarcinoma: Role of Family History and Germ-Line p16, BRCA1, and BRCA2 Mutations. Cancer Res.
60: 409-416
[Abstract][Full Text]
Spain, B. H., Larson, C. J., Shihabuddin, L. S., Gage, F. H., Verma, I. M.
(1999). Truncated BRCA2 is cytoplasmic: Implications for cancer-linked mutations. Proc. Natl. Acad. Sci. USA
96: 13920-13925
[Abstract][Full Text]
Haber, D. A.
(1999). Breast Cancer in Carriers of BRCA1 and BRCA2 Mutations: Tackling a Molecular and Clinical Conundrum. JCO
17: 3367-3370
[Full Text]
Phillips, K.-A., Andrulis, I. L., Goodwin, P. J.
(1999). Breast Carcinomas Arising in Carriers of Mutations in BRCA1 or BRCA2: Are They Prognostically Different?. JCO
17: 3653-3663
[Abstract][Full Text]
Barton, M. B., Harris, R., Fletcher, S. W.
(1999). Does This Patient Have Breast Cancer?: The Screening Clinical Breast Examination: Should It Be Done? How?. JAMA
282: 1270-1280
[Abstract][Full Text]
Bell, D. W., Wahrer, D. C. R., Kang, D. H., MacMahon, M. S., FitzGerald, M. G., Ishioka, C., Isselbacher, K. J., Krainer, M., Haber, D. A.
(1999). Common Nonsense Mutations in RAD52. Cancer Res.
59: 3883-3888
[Abstract][Full Text]
Warner, E., Foulkes, W., Goodwin, P., Meschino, W., Blondal, J., Paterson, C., Ozcelik, H., Goss, P., Allingham-Hawkins, D., Hamel, N., Di Prospero, L., Contiga, V., Serruya, C., Klein, M., Moslehi, R., Honeyford, J., Liede, A., Glendon, G., Brunet, J.-S., Narod, S.
(1999). Prevalence and Penetrance of BRCA1 and BRCA2 Gene Mutations in Unselected Ashkenazi Jewish Women With Breast Cancer. JNCI J Natl Cancer Inst
91: 1241-1247
[Abstract][Full Text]
Peto, J., Collins, N., Barfoot, R., Seal, S., Warren, W., Rahman, N., Easton, D. F., Evans, C., Deacon, J., Stratton, M. R.
(1999). Prevalence of BRCA1 and BRCA2 Gene Mutations in Patients With Early-Onset Breast Cancer. JNCI J Natl Cancer Inst
91: 943-949
[Abstract][Full Text]
Tang, N. L. S., Pang, C.-P., Yeo, W., Choy, K.-W., Lam, P. K., Suen, M., Law, L. K., King, W. W. K., Johnson, P., Hjelm, M.
(1999). Prevalence of Mutations in the BRCA1 Gene Among Chinese Patients With Breast Cancer. JNCI J Natl Cancer Inst
91: 882-885
[Full Text]
de Bock, G., Vlieland, T. V., Hageman, G., Oosterwijk, J., Springer, M., Kievit, J
(1999). The assessment of genetic risk of breast cancer: a set of GP guidelines. Fam Pract
16: 71-77
[Abstract][Full Text]
Lynch, H. T., Casey, M. J., Shaw, T. G., Lynch, J. F.
(1998). Hereditary Factors in Gynecologic Cancer. The Oncologist
3: 319-338
[Abstract][Full Text]
Newman, B., Mu, H., Butler, L. M., Millikan, R. C., Moorman, P. G., King, M.-C.
(1998). Frequency of Breast Cancer Attributable to BRCA1 in a Population-Based Series of American Women. JAMA
279: 915-921
[Abstract][Full Text]
Malone, K. E., Daling, J. R., Thompson, J. D., O'Brien, C. A., Francisco, L. V., Ostrander, E. A.
(1998). 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
279: 922-929
[Abstract][Full Text]
Couch, F. J., Hartmann, L. C.
(1998). BRCA1 Testing--Advances and Retreats. JAMA
279: 955-957
[Full Text]
Orlando, R., Birkmeyer, J. D., Welch, H. G., Meijer, W. J., van Lindert, A. C.M., Grann, V., Whittemore, A. S., Schrag, D., Weeks, J. C.
(1997). Risk of Breast Cancer in Carriers of BRCA Gene Mutations. NEJM
337: 787-789
[Full Text]
(1997). What to Make of the Genetic Picture of Breast Cancer?. JWatch Women's Health
1997: 5-5
[Full Text]
(1997). *BRCA* GENES AND BREAST CANCER RISK. JWatch General
1997: 3-3
[Full Text]
Healy, B.
(1997). BRCA Genes -- Bookmaking, Fortunetelling, and Medical Care. NEJM
336: 1448-1449
[Full Text]
Schrag, D., Kuntz, K. M., Garber, J. E., Weeks, J. C.
(1997). Decision Analysis -- Effects of Prophylactic Mastectomy and Oophorectomy on Life Expectancy among Women with BRCA1 or BRCA2 Mutations. NEJM
336: 1465-1471
[Abstract][Full Text]