BRST5:The polygenic component of breast cancer susceptibility: Difference between revisions
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<span style="color:#0070C0">(''General Instructions – The | [[BRST5:Table_of_Contents|Breast Tumours (WHO Classification, 5th ed.)]] | ||
{{Under Construction}} | |||
<span style="color:#0070C0">(''General Instructions – The focus of these pages is the clinically significant genetic alterations in each disease type. This is based on up-to-date knowledge from multiple resources such as PubMed and the WHO classification books. The CCGA is meant to be a supplemental resource to the WHO classification books; the CCGA captures in a continually updated wiki-stye manner the current genetics/genomics knowledge of each disease, which evolves more rapidly than books can be revised and published. If the same disease is described in multiple WHO classification books, the genetics-related information for that disease will be consolidated into a single main page that has this template (other pages would only contain a link to this main page). Use [https://www.genenames.org/ <u>HUGO-approved gene names and symbols</u>] (italicized when appropriate), [https://varnomen.hgvs.org/ <u>HGVS-based nomenclature for variants</u>], as well as generic names of drugs and testing platforms or assays if applicable. Please complete tables whenever possible and do not delete them (add N/A if not applicable in the table and delete the examples); to add (or move) a row or column in a table, click nearby within the table and select the > symbol that appears. Please do not delete or alter the section headings. The use of bullet points alongside short blocks of text rather than only large paragraphs is encouraged. Additional instructions below in italicized blue text should not be included in the final page content. Please also see'' </span><u>''[[Author_Instructions]]''</u><span style="color:#0070C0"> ''and [[Frequently Asked Questions (FAQs)|<u>FAQs</u>]] as well as contact your [[Leadership|<u>Associate Editor</u>]] or [mailto:CCGA@cancergenomics.org <u>Technical Support</u>].)''</span> | |||
==Primary Author(s)*== | ==Primary Author(s)*== | ||
Xiaolin Hu | Xiaolin Hu, GeneDx | ||
==WHO Classification of Disease== | ==WHO Classification of Disease== | ||
{| class="wikitable" | {| class="wikitable" | ||
!Structure | !Structure | ||
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|- | |- | ||
|Book | |Book | ||
| | |Breast Tumours (5th ed.) | ||
|- | |- | ||
|Category | |Category | ||
| | |Genetic tumour syndromes of the breast | ||
|- | |- | ||
|Family | |Family | ||
| | |Syndromes | ||
|- | |- | ||
|Type | |Type | ||
| | |Polygenetic component of breast cancer susceptibility | ||
|- | |- | ||
|Subtype(s) | |Subtype(s) | ||
| | |N/A | ||
|} | |} | ||
==Related Terminology== | |||
== | |||
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| | |+ | ||
| | |Acceptable | ||
|N/A | |||
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| | |Not Recommended | ||
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|} | |} | ||
== | Polygenic breast cancer risk; Common low-penetrance breast cancer alleles | ||
Put your text here <span style="color:#0070C0">('' | |||
== | ==Definition/Description of Disease== | ||
Put your text here <span style="color:#0070C0">(''Instructions: Include a brief general clinical description, diagnostic criteria, and differential diagnosis if applicable. Include disease context relative to other WHO classification categories, i.e. describe any information relevant to the genetic aspects of the disease from all WHO classification books in which the syndrome is described.'')</span> | |||
== | |||
Put your text here and fill in the table <span style="color:#0070C0">('' | The polygenic component of breast cancer refers to the combined effect of many common SNPs, each conferring a small increase in risk, typically under 1.3-fold. Identified mainly through GWAS, these low-penetrance variants collectively explain 18–20% of familial breast cancer risk and are quantified using a polygenic risk score (PRS) <ref name=":0">{{Cite journal|last=Michailidou|first=Kyriaki|last2=Lindström|first2=Sara|last3=Dennis|first3=Joe|last4=Beesley|first4=Jonathan|last5=Hui|first5=Shirley|last6=Kar|first6=Siddhartha|last7=Lemaçon|first7=Audrey|last8=Soucy|first8=Penny|last9=Glubb|first9=Dylan|date=2017-11-02|title=Association analysis identifies 65 new breast cancer risk loci|url=https://pubmed.ncbi.nlm.nih.gov/29059683|journal=Nature|volume=551|issue=7678|pages=92–94|doi=10.1038/nature24284|issn=1476-4687|pmc=5798588|pmid=29059683}}</ref><ref name=":1">{{Cite journal|last=Mavaddat|first=Nasim|last2=Pharoah|first2=Paul D. P.|last3=Michailidou|first3=Kyriaki|last4=Tyrer|first4=Jonathan|last5=Brook|first5=Mark N.|last6=Bolla|first6=Manjeet K.|last7=Wang|first7=Qin|last8=Dennis|first8=Joe|last9=Dunning|first9=Alison M.|date=2015-05|title=Prediction of breast cancer risk based on profiling with common genetic variants|url=https://pubmed.ncbi.nlm.nih.gov/25855707|journal=Journal of the National Cancer Institute|volume=107|issue=5|pages=djv036|doi=10.1093/jnci/djv036|issn=1460-2105|pmc=4754625|pmid=25855707}}</ref>. There are no specific histologic features directly attributable to polygenic risk alleles. However, these variants tend to be enriched in specific breast cancer subtypes. For example, ER-positive tumors, which are estrogen receptor–driven and often of ductal histology, are more strongly associated with many common susceptibility alleles. In contrast, ER-negative tumors, including those seen more frequently in BRCA1 mutation carriers, show enrichment for a smaller subset of variants. Similarly, lobular carcinomas—characterized by a lack of E-cadherin expression—have been associated with unique risk variants distinct from those found in ductal carcinomas<ref name=":2">{{Cite journal|last=Sawyer|first=Elinor|last2=Roylance|first2=Rebecca|last3=Petridis|first3=Christos|last4=Brook|first4=Mark N.|last5=Nowinski|first5=Salpie|last6=Papouli|first6=Efterpi|last7=Fletcher|first7=Olivia|last8=Pinder|first8=Sarah|last9=Hanby|first9=Andrew|date=2014-04|title=Genetic predisposition to in situ and invasive lobular carcinoma of the breast|url=https://pubmed.ncbi.nlm.nih.gov/24743323|journal=PLoS genetics|volume=10|issue=4|pages=e1004285|doi=10.1371/journal.pgen.1004285|issn=1553-7404|pmc=3990493|pmid=24743323}}</ref>. SNPs in FGFR2 are more common in ER-positive ductal carcinoma; variants in 7q34 are associated with lobular carcinoma; ER-negative cancers (e.g., seen in BRCA1 carriers) are linked to 19p13.1 variants<ref name=":2" /><ref>{{Cite journal|last=Mavaddat|first=Nasim|last2=Barrowdale|first2=Daniel|last3=Andrulis|first3=Irene L.|last4=Domchek|first4=Susan M.|last5=Eccles|first5=Diana|last6=Nevanlinna|first6=Heli|last7=Ramus|first7=Susan J.|last8=Spurdle|first8=Amanda|last9=Robson|first9=Mark|date=2012-01|title=Pathology of breast and ovarian cancers among BRCA1 and BRCA2 mutation carriers: results from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA)|url=https://pubmed.ncbi.nlm.nih.gov/22144499|journal=Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology|volume=21|issue=1|pages=134–147|doi=10.1158/1055-9965.EPI-11-0775|issn=1538-7755|pmc=3272407|pmid=22144499}}</ref><ref>{{Cite journal|last=Kuchenbaecker|first=Karoline B.|last2=Neuhausen|first2=Susan L.|last3=Robson|first3=Mark|last4=Barrowdale|first4=Daniel|last5=McGuffog|first5=Lesley|last6=Mulligan|first6=Anna Marie|last7=Andrulis|first7=Irene L.|last8=Spurdle|first8=Amanda B.|last9=Schmidt|first9=Marjanka K.|date=2014-12-31|title=Associations of common breast cancer susceptibility alleles with risk of breast cancer subtypes in BRCA1 and BRCA2 mutation carriers|url=https://pubmed.ncbi.nlm.nih.gov/25919761|journal=Breast cancer research: BCR|volume=16|issue=6|pages=3416|doi=10.1186/s13058-014-0492-9|issn=1465-542X|pmc=4406179|pmid=25919761}}</ref>. | ||
==Epidemiology/Prevalence== | |||
Over 170 low-penetrance alleles have been identified, primarily in populations of European descent, accounting for approximately 18% of familial breast cancer risk<ref>{{Cite journal|last=Adam|first=Kevin|last2=Hunter|first2=Tony|date=2018-02|title=Histidine kinases and the missing phosphoproteome from prokaryotes to eukaryotes|url=https://pubmed.ncbi.nlm.nih.gov/29058706|journal=Laboratory Investigation; a Journal of Technical Methods and Pathology|volume=98|issue=2|pages=233–247|doi=10.1038/labinvest.2017.118|issn=1530-0307|pmc=5815933|pmid=29058706}}</ref>. These loci are found in the general population with varying allele frequencies and are being increasingly incorporated into risk prediction models. | |||
==Genetic Abnormalities: Germline== | |||
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Describe germline alteration(s) that cause the syndrome. In the notes, include additional details about most common mutations including founder mutations, mechanisms of molecular pathogenesis, alteration-specific prognosis and any other important genetics-related information. If multiple causes of the syndrome, include relative prevalence of genetic contributions to that syndrome. Please include references throughout the table. Do not delete the table.'')</span> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
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! | !Gene!!Genetic Variant or Variant Type!!Molecular Pathogenesis!!Inheritance, Penetrance, Expressivity | ||
!Notes | |||
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| | |Multiple Genes(FGFR2, MAP3K1, TOX3 etc)||Many SNPs (Common, minor allele frequency >1%)||Affect regulatory region or epigenetics rather than traditional oncogenes/tumor suppressor genes ||complex inheritance: non-Mendelian, polygenic pattern; their effects are additive or multiplicative and are often influenced by environment; Penetrance: each SNP confer very modest risk (<1.3 fold), but cumulative penetrance increases with a higher PRS; Expressivity: variable. PRS may influence age of onset, tumor subtype or morphology | ||
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'''PLEASE PUT CONTENT FROM OLD TABLE BELOW WHERE YOU WANT IT AND THEN DELETE THE OLD TABLE.''' | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
! | !Gene; Genetic Alteration!!'''Presumed Mechanism (Tumor Suppressor Gene [TSG] / Oncogene / Other)'''!!'''Prevalence (COSMIC / TCGA / Other)'''!!'''Concomitant Mutations'''!!'''Mutually Exclusive Mutations''' | ||
!Diagnostic Significance (Yes, No or Unknown) | !'''Diagnostic Significance (Yes, No or Unknown)''' | ||
!Prognostic Significance (Yes, No or Unknown) | !Prognostic Significance (Yes, No or Unknown) | ||
!Therapeutic Significance (Yes, No or Unknown) | !Therapeutic Significance (Yes, No or Unknown) | ||
!Notes | !Notes | ||
|- | |- | ||
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|Regulatory/epigenetic, not traditional oncogenes/TSGs | |||
| | |Common, MAF >1% | ||
| | |Varies | ||
| | |Varies | ||
| | |No | ||
|Limited | |||
|Yes (PRS applications | |||
|Target gene expression changes may affect oncogenic pathways | |||
|} | |} | ||
== | ==Genetic Abnormalities: Somatic== | ||
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: | Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Describe significant second hit mutations, or somatic variants that present as a germline syndrome. In the notes, include details about most common mutations, mechanisms of molecular pathogenesis, alteration-specific prognosis and any other important genetic-related information. Please include references throughout the table. Do not delete the table.'')</span> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
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! | !Gene!!Genetic Variant or Variant Type!!Molecular Pathogenesis!!Inheritance, Penetrance, Expressivity | ||
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!Notes | !Notes | ||
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|<span class="blue-text">EXAMPLE:</span> | |<span class="blue-text">EXAMPLE:</span> ''BRCA1''||<span class="blue-text">EXAMPLE:</span> Biallelic inactivation variants||<span class="blue-text">EXAMPLE:</span> Second hit mutation can occur as copy neutral LOH, inactivating mutation, deletion, promoter hypermethylation, or a structural abnormality disrupting the gene.|| | ||
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|<span class="blue-text">EXAMPLE:</span> | |||
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|<span class="blue-text">EXAMPLE:</span> | |<span class="blue-text">EXAMPLE:</span> ''BRCA1'' | ||
|<span class="blue-text">EXAMPLE:</span> Reversion mutation | |||
|<span class="blue-text">EXAMPLE:</span> | |<span class="blue-text">EXAMPLE:</span> After exposure to certain therapies (e.g. PARP inhibitors), a second mutation may restore gene function as a resistance mechanism. | ||
|<span class="blue-text">EXAMPLE:</span> | | | ||
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== | ==Genes and Main Pathways Involved== | ||
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: | Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Please include references throughout the table. Do not delete the table.)''</span> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
!Gene; Genetic Alteration!! | !Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | ||
|- | |- | ||
| | |''MAP3K1'' | ||
|MAPK/ERK pathway | |||
|Alters cell survival and signal transduction | |||
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|- | |- | ||
|''FGFR2'' | |||
|FGF signaling | |||
|Increases proliferation | |||
|- | |- | ||
| | |''TOX3'' | ||
| | |Chromatin remodeling | ||
| | |Affects transcriptional regulation and stress response | ||
|- | |- | ||
| | |''ESR1'' | ||
| | |Estrogen receptor signaling | ||
| | |Modulates hormonal response in luminal cells | ||
|- | |- | ||
| | |CDKN2B | ||
| | |Cell cycle checkpoint | ||
| | |Dysregulates cell cycle progression | ||
|} | |} | ||
==Genetic Diagnostic Testing Methods== | ==Genetic Diagnostic Testing Methods== | ||
Polygenic risk is assessed through genotyping panels or whole-genome SNP arrays followed by computational calculation of the PRS<ref>{{Cite journal|last=Sawyer|first=Sarah|last2=Mitchell|first2=Gillian|last3=McKinley|first3=Joanne|last4=Chenevix-Trench|first4=Georgia|last5=Beesley|first5=Jonathan|last6=Chen|first6=Xiao Qing|last7=Bowtell|first7=David|last8=Trainer|first8=Alison H.|last9=Harris|first9=Marion|date=2012-12-10|title=A role for common genomic variants in the assessment of familial breast cancer|url=https://pubmed.ncbi.nlm.nih.gov/23109704|journal=Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology|volume=30|issue=35|pages=4330–4336|doi=10.1200/JCO.2012.41.7469|issn=1527-7755|pmid=23109704}}</ref><ref>{{Cite journal|last=Dite|first=Gillian S.|last2=MacInnis|first2=Robert J.|last3=Bickerstaffe|first3=Adrian|last4=Dowty|first4=James G.|last5=Allman|first5=Richard|last6=Apicella|first6=Carmel|last7=Milne|first7=Roger L.|last8=Tsimiklis|first8=Helen|last9=Phillips|first9=Kelly-Anne|date=2016-02|title=Breast Cancer Risk Prediction Using Clinical Models and 77 Independent Risk-Associated SNPs for Women Aged Under 50 Years: Australian Breast Cancer Family Registry|url=https://pubmed.ncbi.nlm.nih.gov/26677205|journal=Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology|volume=25|issue=2|pages=359–365|doi=10.1158/1055-9965.EPI-15-0838|issn=1538-7755|pmc=4767544|pmid=26677205}}</ref><ref name=":1" />. | |||
== | |||
==Additional Information== | ==Additional Information== | ||
These low-penetrance alleles can act additively or multiplicatively with rare high-penetrance pathogenic variants (e.g., BRCA1, BRCA2) and may modify cancer risk within families with hereditary breast and ovarian cancer syndromes<ref>{{Cite journal|last=Kuchenbaecker|first=Karoline B.|last2=McGuffog|first2=Lesley|last3=Barrowdale|first3=Daniel|last4=Lee|first4=Andrew|last5=Soucy|first5=Penny|last6=Dennis|first6=Joe|last7=Domchek|first7=Susan M.|last8=Robson|first8=Mark|last9=Spurdle|first9=Amanda B.|date=2017-07-01|title=Evaluation of Polygenic Risk Scores for Breast and Ovarian Cancer Risk Prediction in BRCA1 and BRCA2 Mutation Carriers|url=https://pubmed.ncbi.nlm.nih.gov/28376175|journal=Journal of the National Cancer Institute|volume=109|issue=7|pages=djw302|doi=10.1093/jnci/djw302|issn=1460-2105|pmc=5408990|pmid=28376175}}</ref>. | |||
The utility of PRS in clinical practice is growing, both for general population risk stratification and for risk modification in individuals with known pathogenic variants in high-risk genes<ref>{{Cite journal|last=Kuchenbaecker|first=Karoline B.|last2=McGuffog|first2=Lesley|last3=Barrowdale|first3=Daniel|last4=Lee|first4=Andrew|last5=Soucy|first5=Penny|last6=Dennis|first6=Joe|last7=Domchek|first7=Susan M.|last8=Robson|first8=Mark|last9=Spurdle|first9=Amanda B.|date=2017-07-01|title=Evaluation of Polygenic Risk Scores for Breast and Ovarian Cancer Risk Prediction in BRCA1 and BRCA2 Mutation Carriers|url=https://pubmed.ncbi.nlm.nih.gov/28376175|journal=Journal of the National Cancer Institute|volume=109|issue=7|pages=djw302|doi=10.1093/jnci/djw302|issn=1460-2105|pmc=5408990|pmid=28376175}}</ref>. | |||
==Links== | ==Links== | ||
Put a link here or anywhere appropriate in this page <span style="color:#0070C0">(''Instructions: Highlight the text to which you want to add a link in this section or elsewhere, select the "Link" icon at the top of the wiki page, and search the name of the internal page to which you want to link this text, or enter an external internet address by including the "<nowiki>http://www</nowiki>." portion.'')</span> | |||
==References== | ==References== | ||
[[Category:BRST5]] | |||
[[Category:DISEASE]] | |||
<references /> | |||
==Notes== | ==Notes== | ||
<nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page. | <nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page. If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the [[Leadership|''<u>Associate Editor</u>'']] or other CCGA representative. When pages have a major update, the new author will be acknowledged at the beginning of the page, and those who contributed previously will be acknowledged below as a prior author. | ||
Prior Author(s): | |||