Cancer Res Treat.  2022 Jul;54(3):827-833. 10.4143/crt.2021.791.

Clinicopathological Characterization of Double Heterozygosity for BRCA1 and BRCA2 Variants in Korean Breast Cancer Patients

Affiliations
  • 1Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Laboratory and Genetics, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Purpose
Double heterozygosity (DH) for BRCA1 and BRCA2 variant is very rare with only a few cases reported, and most those in Caucasians. In this article, we present seven unrelated cases of DH for BRCA1/2 identified from a single institution in Korea, and describe the characteristics and phenotype of DH individuals compared to those with a single BRCA variant.
Materials and Methods
This study included 27,678 patients diagnosed with breast cancer and surgically treated at Samsung Medical Center (SMC) between January 2008 and June 2020. In total, 4,215 high-risk breast cancer patients were tested for the BRCA1/2 genes, and electronic medical records from 456 cases with pathogenic/likely pathogenic variants (PVs/LPVs) were reviewed.
Results
A younger mean age at diagnosis was associated with DH than a single variant of BRCA1/2. More triple-negative breast cancer (TNBC) and higher nuclear and histologic grade cancer occurred with DH than BRCA2 variant. All 7 cases of DH were unrelated, and their mutation combinations were different. There were no Ashkenazi founder variants detected.
Conclusion
We suggest that patients with DH for BRCA1/2 variants develop breast cancer at a younger age, but the histopathologic features are similar to those of BRCA1.

Keyword

Double heterozygosity; Hereditary breast cancer

Reference

References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016; 66:7–30.
Article
2. Miki Y, Swensen J, Shattuck-Eidens D, Futreal PA, Harshman K, Tavtigian S, et al. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science. 1994; 266:66–71.
Article
3. Wooster R, Bignell G, Lancaster J, Swift S, Seal S, Mangion J, et al. Identification of the breast cancer susceptibility gene BRCA2. Nature. 1995; 378:789–92.
Article
4. Choi DH, Lee MH, Bale AE, Carter D, Haffty BG. Incidence of BRCA1 and BRCA2 mutations in young Korean breast cancer patients. J Clin Oncol. 2004; 22:1638–45.
5. Han SH, Lee KR, Lee DG, Kim BY, Lee KE, Chung WS. Mutation analysis of BRCA1 and BRCA2 from 793 Korean patients with sporadic breast cancer. Clin Genet. 2006; 70:496–501.
Article
6. Ahn SH, Son BH, Yoon KS, Noh DY, Han W, Kim SW, et al. BRCA1 and BRCA2 germline mutations in Korean breast cancer patients at high risk of carrying mutations. Cancer Lett. 2007; 245:90–5.
Article
7. Atchley DP, Albarracin CT, Lopez A, Valero V, Amos CI, Gonzalez-Angulo AM, et al. Clinical and pathologic characteristics of patients with BRCA-positive and BRCA-negative breast cancer. J Clin Oncol. 2008; 26:4282–8.
8. Copson ER, Maishman TC, Tapper WJ, Cutress RI, Greville-Heygate S, Altman DG, et al. Germline BRCA mutation and outcome in young-onset breast cancer (POSH): a prospective cohort study. Lancet Oncol. 2018; 19:169–80.
Article
9. Veronesi A, de Giacomi C, Magri MD, Lombardi D, Zanetti M, Scuderi C, et al. Familial breast cancer: characteristics and outcome of BRCA 1–2 positive and negative cases. BMC Cancer. 2005; 5:70.
Article
10. Musolino A, Bella MA, Bortesi B, Michiara M, Naldi N, Zanelli P, et al. BRCA mutations, molecular markers, and clinical variables in early-onset breast cancer: a population-based study. Breast. 2007; 16:280–92.
Article
11. Atci MM, Geredeli C, Ay S, Sakin A, Erturk B, Secmeler S, et al. Clinical and pathological characteristics of patients with high-risk breast cancer based on BRCA mutation profiles: a retrospective study. Eur J Breast Health. 2021; 17:123–7.
Article
12. Lavie O, Narod S, Lejbkowicz F, Dishon S, Goldberg Y, Gemer O, et al. Double heterozygosity in the BRCA1 and BRCA2 genes in the Jewish population. Ann Oncol. 2011; 22:964–6.
Article
13. Leegte B, van der Hout AH, Deffenbaugh AM, Bakker MK, Mulder IM, ten Berge A, et al. Phenotypic expression of double heterozygosity for BRCA1 and BRCA2 germline mutations. J Med Genet. 2005; 42:e20.
Article
14. Smith M, Fawcett S, Sigalas E, Bell R, Devery S, Andrieska N, et al. Familial breast cancer: double heterozygosity for BRCA1 and BRCA2 mutations with differing phenotypes. Fam Cancer. 2008; 7:119–24.
Article
15. Rebbeck TR, Friebel TM, Mitra N, Wan F, Chen S, Andrulis IL, et al. Inheritance of deleterious mutations at both BRCA1 and BRCA2 in an international sample of 32,295 women. Breast Cancer Res. 2016; 18:112.
16. Heidemann S, Fischer C, Engel C, Fischer B, Harder L, Schlegelberger B, et al. Double heterozygosity for mutations in BRCA1 and BRCA2 in German breast cancer patients: implications on test strategies and clinical management. Breast Cancer Res Treat. 2012; 134:1229–39.
Article
17. Noh JM, Choi DH, Nam SJ, Lee JE, Kim JW, Kim SW, et al. Characteristics of double heterozygosity for BRCA1 and BRCA2 germline mutations in Korean breast cancer patients. Breast Cancer Res Treat. 2012; 131:217–22.
Article
18. Musolino A, Naldi N, Michiara M, Bella MA, Zanelli P, Bortesi B, et al. A breast cancer patient from Italy with germline mutations in both the BRCA1 and BRCA2 genes. Breast Cancer Res Treat. 2005; 91:203–5.
Article
19. Bayraktar S, Arun B. BRCA mutation genetic testing implications in the United States. Breast. 2017; 31:224–32.
Article
20. Nomizu T, Matsuzaki M, Katagata N, Kobayashi Y, Sakuma T, Monma T, et al. A case of familial breast cancer with double heterozygosity for BRCA1 and BRCA2 genes. Breast Cancer. 2015; 22:557–61.
Article
21. Richards S, Aziz N, Bale S, Bick D, Das S, Gastier-Foster J, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med. 2015; 17:405–24.
Article
22. Rennert G, Bisland-Naggan S, Barnett-Griness O, Bar-Joseph N, Zhang S, Rennert HS, et al. Clinical outcomes of breast cancer in carriers of BRCA1 and BRCA2 mutations. N Engl J Med. 2007; 357:115–23.
Article
23. Kang E, Seong MW, Park SK, Lee JW, Lee J, Kim LS, et al. The prevalence and spectrum of BRCA1 and BRCA2 mutations in Korean population: recent update of the Korean Hereditary Breast Cancer (KOHBRA) study. Breast Cancer Res Treat. 2015; 151:157–68.
Article
24. Ryu JM, Kang G, Nam SJ, Kim SW, Yu J, Lee SK, et al. Suggestion of BRCA1 c.5339T>C (p.L1780P) variant confer from ‘unknown significance’ to ‘Likely pathogenic’ based on clinical evidence in Korea. Breast. 2017; 33:109–16.
Article
25. Mehta PA, Ebens C. Fanconi anemia Gene Reviews [Internet]. Seattle, WA: University of Washington, Seattle;2018. [cited 2021 Aug 1]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1401/ .
26. Ramus SJ, Friedman LS, Gayther SA, Ponder BA, Bobrow L, van der Looji M, et al. A breast/ovarian cancer patient with germline mutations in both BRCA1 and BRCA2. Nat Genet. 1997; 15:14–5.
Article
Full Text Links
  • CRT
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr