Breast cancer risks associated with missense variants in breast cancer susceptibility genes

Author:

Dorling Leila,Carvalho Sara,Allen Jamie,Parsons Michael T.,Fortuno Cristina,González-Neira Anna,Heijl Stephan M.,Adank Muriel A.,Ahearn Thomas U.,Andrulis Irene L.,Auvinen Päivi,Becher Heiko,Beckmann Matthias W.,Behrens Sabine,Bermisheva Marina,Bogdanova Natalia V.,Bojesen Stig E.,Bolla Manjeet K.,Bremer Michael,Briceno Ignacio,Camp Nicola J.,Campbell Archie,Castelao Jose E.,Chang-Claude Jenny,Chanock Stephen J.,Chenevix-Trench Georgia,Collée J. Margriet,Czene Kamila,Dennis Joe,Dörk Thilo,Eriksson Mikael,Evans D. Gareth,Fasching Peter A.,Figueroa Jonine,Flyger Henrik,Gabrielson Marike,Gago-Dominguez Manuela,García-Closas Montserrat,Giles Graham G.,Glendon Gord,Guénel Pascal,Gündert Melanie,Hadjisavvas Andreas,Hahnen Eric,Hall Per,Hamann Ute,Harkness Elaine F.,Hartman Mikael,Hogervorst Frans B. L.,Hollestelle Antoinette,Hoppe Reiner,Howell Anthony,Jakubowska Anna,Jung Audrey,Khusnutdinova Elza,Kim Sung-Won,Ko Yon-Dschun,Kristensen Vessela N.,Lakeman Inge M. M.,Li Jingmei,Lindblom Annika,Loizidou Maria A.,Lophatananon Artitaya,Lubiński Jan,Luccarini Craig,Madsen Michael J.,Mannermaa Arto,Manoochehri Mehdi,Margolin Sara,Mavroudis Dimitrios,Milne Roger L.,Mohd Taib Nur Aishah,Muir Kenneth,Nevanlinna Heli,Newman William G.,Oosterwijk Jan C.,Park Sue K.,Peterlongo Paolo,Radice Paolo,Saloustros Emmanouil,Sawyer Elinor J.,Schmutzler Rita K.,Shah Mitul,Sim Xueling,Southey Melissa C.,Surowy Harald,Suvanto Maija,Tomlinson Ian,Torres Diana,Truong Thérèse,van Asperen Christi J.,Waltes Regina,Wang Qin,Yang Xiaohong R.,Pharoah Paul D. P.,Schmidt Marjanka K.,Benitez Javier,Vroling Bas,Dunning Alison M.,Teo Soo Hwang,Kvist Anders,de la Hoya Miguel,Devilee Peter,Spurdle Amanda B.,Vreeswijk Maaike P. G.,Easton Douglas F., , ,

Abstract

Abstract Background Protein truncating variants in ATM, BRCA1, BRCA2, CHEK2, and PALB2 are associated with increased breast cancer risk, but risks associated with missense variants in these genes are uncertain. Methods We analyzed data on 59,639 breast cancer cases and 53,165 controls from studies participating in the Breast Cancer Association Consortium BRIDGES project. We sampled training (80%) and validation (20%) sets to analyze rare missense variants in ATM (1146 training variants), BRCA1 (644), BRCA2 (1425), CHEK2 (325), and PALB2 (472). We evaluated breast cancer risks according to five in silico prediction-of-deleteriousness algorithms, functional protein domain, and frequency, using logistic regression models and also mixture models in which a subset of variants was assumed to be risk-associated. Results The most predictive in silico algorithms were Helix (BRCA1, BRCA2 and CHEK2) and CADD (ATM). Increased risks appeared restricted to functional protein domains for ATM (FAT and PIK domains) and BRCA1 (RING and BRCT domains). For ATM, BRCA1, and BRCA2, data were compatible with small subsets (approximately 7%, 2%, and 0.6%, respectively) of rare missense variants giving similar risk to those of protein truncating variants in the same gene. For CHEK2, data were more consistent with a large fraction (approximately 60%) of rare missense variants giving a lower risk (OR 1.75, 95% CI (1.47–2.08)) than CHEK2 protein truncating variants. There was little evidence for an association with risk for missense variants in PALB2. The best fitting models were well calibrated in the validation set. Conclusions These results will inform risk prediction models and the selection of candidate variants for functional assays and could contribute to the clinical reporting of gene panel testing for breast cancer susceptibility.

Funder

Horizon 2020

Wellcome Trust

Cancer Research UK

Publisher

Springer Science and Business Media LLC

Subject

Genetics (clinical),Genetics,Molecular Biology,Molecular Medicine

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