Somatic inactivation of breast cancer predisposition genes in tumors associated with pathogenic germline variants

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Abstract
Breast cancers (BC) that arise in individuals heterozygous for a germline pathogenic variant in a susceptibility gene, such as BRCA1/2, PALB2 and RAD51C, have been shown to exhibit bi-allelic loss in the respective genes, and be associated with triple-negative (TN) BC and distinctive somatic mutational signatures. Tumour sequencing thus presents an orthogonal approach to assess the role of candidate genes in BC development. Exome sequencing was performed on paired normal-breast tumour DNA from 124 carriers of germline loss-of-function (LoF) or missense (MS) mutations carriers in 15 known and candidate BC predisposition genes identified in the BEACCON case-control study. Bi-allelic inactivation and association with tumour genome features including mutational signatures and homologous recombination deficiency (HRD) score were investigated. BARD1-carrying TN BC (4/5) displayed bi-allelic loss and associated high HRD scores and mutational signature 3, as did a RAD51D-carrying TN BC and ovarian cancer. Bi-allelic loss was less frequent in BRIP1 BCs (4/13) and had low HRD scores. In contrast to other established BC genes, BCs from carriers of CHEK2 LoF (6/17) or MS (2/20) carriers had low rates of bi-allelic loss. Exploratory analysis of BC from carriers of LoF mutations in candidate genes such as BLM, FANCM, PARP2 and RAD50 found little evidence of bi-allelic inactivation. BARD1 and RAD51D behave as classic BRCA-like genes with bi-allelic inactivation but this was not observed for any of the candidate genes. However, as demonstrated for CHEK2, the absence of bi-allelic inactivation does not provide definitive evidence against the gene’s involvement in BC predisposition.
Funding Information
  • National Breast Cancer Foundation (IF-15-004)
  • National Breast Cancer Foundation (PdCCRS_1107870)
  • National Breast Cancer Foundation (PdCCRS_1188547)
  • Victorian Cancer Agency
  • National Health and Medical Research Council of Australia (GNT1023698, GNT1041975)
  • Cancer Australia (PdCCRS_1188547)
  • National Health and Medical Research Council (GNT114749)
  • National Breast Cancer Foundation (IIRS-20-025)
  • Cancer Council Victoria Grants-in-Aid
  • Cancer Council Victoria

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