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Åke Borg

Åke Borg

Principal investigator

Åke Borg

Extended genetic analysis and tumor characteristics in over 4600 women with suspected hereditary breast and ovarian cancer

Author

  • Anna Öfverholm
  • Therese Törngren
  • Anna Rosén
  • Brita Arver
  • Zakaria Einbeigi
  • Karin Haraldsson
  • Anne Kinhult Ståhlbom
  • Ekaterina Kuchinskaya
  • Annika Lindblom
  • Beatrice Melin
  • Ylva Paulsson-Karlsson
  • Marie Stenmark-Askmalm
  • Emma Tham
  • Anna von Wachenfeldt
  • Anders Kvist
  • Åke Borg
  • Hans Ehrencrona
Show all

Summary, in English

BACKGROUND: Genetic screening for pathogenic variants (PVs) in cancer predisposition genes can affect treatment strategies, risk prediction and preventive measures for patients and families. For decades, hereditary breast and ovarian cancer (HBOC) has been attributed to PVs in the genes BRCA1 and BRCA2, and more recently other rare alleles have been firmly established as associated with a high or moderate increased risk of developing breast and/or ovarian cancer. Here, we assess the genetic variation and tumor characteristics in a large cohort of women with suspected HBOC in a clinical oncogenetic setting.

METHODS: Women with suspected HBOC referred from all oncogenetic clinics in Sweden over a six-year inclusion period were screened for PVs in 13 clinically relevant genes. The genetic outcome was compared with tumor characteristics and other clinical data collected from national cancer registries and hospital records.

RESULTS: In 4622 women with breast and/or ovarian cancer the overall diagnostic yield (the proportion of women carrying at least one PV) was 16.6%. BRCA1/2 PVs were found in 8.9% of women (BRCA1 5.95% and BRCA2 2.94%) and PVs in the other breast and ovarian cancer predisposition genes in 8.2%: ATM (1.58%), BARD1 (0.45%), BRIP1 (0.43%), CDH1 (0.11%), CHEK2 (3.46%), PALB2 (0.84%), PTEN (0.02%), RAD51C (0.54%), RAD51D (0.15%), STK11 (0) and TP53 (0.56%). Thus, inclusion of the 11 genes in addition to BRCA1/2 increased diagnostic yield by 7.7%. The yield was, as expected, significantly higher in certain subgroups such as younger patients, medullary breast cancer, higher Nottingham Histologic Grade, ER-negative breast cancer, triple-negative breast cancer and high grade serous ovarian cancer. Age and tumor subtype distributions differed substantially depending on genetic finding.

CONCLUSIONS: This study contributes to understanding the clinical and genetic landscape of breast and ovarian cancer susceptibility. Extending clinical genetic screening from BRCA1 and BRCA2 to 13 established cancer predisposition genes almost doubles the diagnostic yield, which has implications for genetic counseling and clinical guidelines. The very low yield in the syndrome genes CDH1, PTEN and STK11 questions the usefulness of including these genes on routine gene panels.

Department/s

  • LUCC: Lund University Cancer Centre
  • Familial Breast Cancer
  • Breastcancer-genetics
  • Division of Clinical Genetics

Publishing year

2023-08-10

Language

English

Pages

1-12

Publication/Series

BMC Cancer

Volume

23

Document type

Journal article

Publisher

BioMed Central (BMC)

Topic

  • Cancer and Oncology

Keywords

  • Humans
  • Female
  • BRCA1 Protein/genetics
  • BRCA2 Protein/genetics
  • Genetic Predisposition to Disease
  • Breast Neoplasms/diagnosis
  • Genetic Testing
  • Ovarian Neoplasms/diagnosis
  • Protein Serine-Threonine Kinases/genetics
  • Triple Negative Breast Neoplasms/genetics
  • Hereditary Breast and Ovarian Cancer Syndrome/diagnosis
  • Germ-Line Mutation

Status

Published

Research group

  • Familial Breast Cancer

ISBN/ISSN/Other

  • ISSN: 1471-2407