Journal Article DKFZ-2025-01084

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Analysis of more than 400,000 women provides case-control evidence for BRCA1 and BRCA2 variant classification.

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2025
Springer Nature [London]

Nature Communications 16(1), 4852 () [10.1038/s41467-025-59979-6]
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Abstract: Clinical genetic testing identifies variants causal for hereditary cancer, information that is used for risk assessment and clinical management. Unfortunately, some variants identified are of uncertain clinical significance (VUS), complicating patient management. Case-control data is one evidence type used to classify VUS. As an initiative of the Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA) Analytical Working Group we analyze germline sequencing data of BRCA1 and BRCA2 from 96,691 female breast cancer cases and 302,116 controls from three studies: the BRIDGES study of the Breast Cancer Association Consortium, the Cancer Risk Estimates Related to Susceptibility consortium, and the UK Biobank. We observe 11,207 BRCA1 and BRCA2 variants, with 6909 being coding, covering 23.4% of BRCA1 and BRCA2 VUS in ClinVar and 19.2% of ClinVar curated (likely) benign or pathogenic variants. Case-control likelihood ratio (ccLR) evidence is highly consistent with ClinVar assertions for (likely) benign or pathogenic variants; exhibiting 99.1% sensitivity and 95.3% specificity for BRCA1 and 93.3% sensitivity and 86.6% specificity for BRCA2. This approach provides case-control evidence for 787 unclassified variants; these include 579 with strong or moderate benign evidence and 10 with strong pathogenic evidence for which ccLR evidence is sufficient to alter clinical classification.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Case-Control Studies (MeSH) ; BRCA2 Protein: genetics (MeSH) ; Breast Neoplasms: genetics (MeSH) ; BRCA1 Protein: genetics (MeSH) ; Genetic Predisposition to Disease (MeSH) ; Genetic Testing (MeSH) ; Germ-Line Mutation (MeSH) ; Middle Aged (MeSH) ; BRCA2 Protein ; BRCA1 Protein ; BRCA2 protein, human ; BRCA1 protein, human

Classification:

Note: Hamann, Ute: Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ),

Contributing Institute(s):
  1. Epidemiologie von Krebs (C020)
  2. Molekulargenetik des Mammakarzinoms (B072)
Research Program(s):
  1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2025
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 Record created 2025-05-26, last modified 2025-08-19



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