Skip to main content
Log in

Two patients with germline mutations in both BRCA1 and BRCA2 discovered unintentionally: a case series and discussion of BRCA testing modalities

  • Brief Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

When a family is known to have a BRCA mutation, genetic testing for family members is typically limited to single site analysis of the known mutation. The exception to this is in Ashkenazi Jewish families, where testing for the three common Ashkenazi Jewish BRCA mutations is recommended. We report two cases, one without Ashkenazi Jewish ancestry and one with maternal Ashkenazi Jewish ancestry, who underwent Comprehensive BRACAnalysis testing despite known BRCA1 mutations in family members. Testing identified the BRCA1 mutation previously identified, and a second mutation in BRCA2. These cases raise the question of whether or not Single Site BRACAnalysis for a known familial BRCA mutation is always the appropriate test when testing an affected individual. The implications of missing a second mutation are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Ramus SJ, Friedman LS, Gayther SA et al (1997) A breast/ovarian cancer patient with germline mutations in both BRCA1 and BRCA2. Nat Genet 15:14–15

    Article  PubMed  CAS  Google Scholar 

  2. Leegte B, van der Hout AH, Deffenbaugh AM et al (2005) Phenotypic expression of double heterozygosity for BRCA1 and BRCA2 germline mutations. J Med Genet 42:e20

    Article  PubMed  CAS  Google Scholar 

  3. Martin M, Ford C, Burbidge LA, Deffenbaugh A, et al. Myriad Genetic Laboratories, Inc Salt Lake City, UT. Poster Presentation at American Society of Human Genetics 56th Annual Meeting. October 9–13. New Orleans, LA

  4. Friedman E, Bar-Sade Bruchim R, Kruglikova A et al (1998) Double heterozygotes for the Ashkenazi founder mutations in BRCA1 and BRCA2 genes. Am J Hum Genet 63:1224–1227

    Article  PubMed  CAS  Google Scholar 

  5. Randall TC, Bell KA, Rebane BA et al (1998) Germline mutations of the BRCA1 and BRCA2 genes in a breast and ovarian cancer patient. Gynecol Oncol 70(3):432–434

    Article  PubMed  CAS  Google Scholar 

  6. Moslehi R, Russo D, Phelan C et al (2000) An unaffected individual from a breast/ovarian cancer family with germline mutations in both BRCA1 and BRCA2. Clin Genet 57(1):70–73

    Article  PubMed  CAS  Google Scholar 

  7. Bell DW, Erban J, Sgroi DC et al (2002) Selective loss of heterozygosity in multiple breast cancer from a carrier of mutation in both BRCA1 and BRCA2. Cancer Res 62:2741–2743

    PubMed  CAS  Google Scholar 

  8. Tsongalis G, Linfer D, Johnson R et al (1998) Double heterozygosity for mutations in BRCA1 and BRCA2 in a breast cancer patient. Arch Pathol Lab Med 122:548–550

    PubMed  CAS  Google Scholar 

  9. Frank TS, Deffenbaugh AM, Reid JE et al (2002) Clinical characteristics of individuals with germline mutations in BRCA1 and BRCA2: analysis of 10, 000 individuals. J Clin Oncol 20:1480–1490

    Article  PubMed  CAS  Google Scholar 

  10. Prat J, Ribe A, Gallardo A (2005) Hereditary ovarian cancer. Hum Pathol 36:861–870

    Article  PubMed  CAS  Google Scholar 

  11. Lavie O, Narod S, Lejbkowica F et al (2011) Double heterozygosity in the BRCA1 and BRCA2 genes in the Jewish population. Ann Oncol 22:964–966. doi:10.1093/annonc/mdq460

    Article  PubMed  CAS  Google Scholar 

  12. Peto J, Collins N, Barfoot R et al (1999) Prevalence of BRCA1 and BRCA2 gene mutations in patients with early-onset breast cancer. J Natl Cancer Inst 91:943–949

    Article  PubMed  CAS  Google Scholar 

  13. Loader S, Rowley PT (1998) Deleterious mutation of both BRCA1 and BRCA2 in three siblings. Genet Test 2:75–77

    Article  PubMed  CAS  Google Scholar 

  14. Tesoriero A, Anderson C, Southey M et al (1999) De novo BRCA1 mutation in a patient with breast cancer and an inherited BRCA2 mutation. Am J Hum Genet 65:567–569

    Article  PubMed  CAS  Google Scholar 

  15. Liede A, Rehal P, Vesprini D et al (1998) A breast cancer patient of Scottish descent with germ-line mutations in BRCA1 and BRCA2. Am J Hum Genet 62:1543–1544

    Article  PubMed  CAS  Google Scholar 

  16. Caldes T, De la Hoya M, Tosar A, Sulleiro S, Godino J, Ibanez D, Martin M, Perez-Segura P, Diaz-Rubio E (2002) A breast cancer family from Spain with germline mutation in both BRCA1 and BRCA2 genes. J Med Genet 39(8):e44

    Article  PubMed  CAS  Google Scholar 

  17. Musolino A, Naldi N, Michiara M et al (2005) A breast cancer family from Italy with germline mutations in both the BRCA1 and BRCA2 genes. Breast Cancer Res Treat 91:203–205

    Article  PubMed  Google Scholar 

  18. Smith M, Fawcett S, Sigalas E, Bell R, Devery S, Andrieska N, Winship I (2008) Familial breast cancer: double heterozygosity for BRCA1 and BRCA2 mutations with differing phenotypes. Fam Cancer 7:119–124

    Article  PubMed  CAS  Google Scholar 

  19. Zuradelli M, Peissel B, Monoukian S et al (2010) Four new cases of double heterozygosity for BRCA1 and BRCA2 gene mutations: clinical, pathological, and family characteristics. Breast Cancer Res Treat 124:251–258

    Article  PubMed  CAS  Google Scholar 

  20. Cremin C, Wong N, Buzaglo K, Paradis A, Foulkes W (2002) Nonovarian pelvic cancers in BRCA1/2 mutation carriers and the BRCAPRO statistical model. J Clin Oncol 20:3936–3937

    Article  PubMed  Google Scholar 

  21. Choi DH, Lee MH, Ball AE, Carter D, Haffty B (2004) Incidence of BRCA1 and BRCA2 mutations in young Korean breast cancer patients. J Clin Oncol 22:1638–1645

    Article  PubMed  CAS  Google Scholar 

  22. Choi DH, Lee MH, Haffty B (2006) Double heterozygotes for Non-Caucasian families with mutations in BRCA-1 and BRCA-2 Genes. Breast J 12:216–220

    Article  PubMed  CAS  Google Scholar 

  23. Pal T, Purmuth-Wey J, Betts JA et al (2005) BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases. Cancer 104:2807–2816

    Article  PubMed  CAS  Google Scholar 

  24. Myriad Genetic Laboratories, Inc. Services and Price List. April 2010

  25. Lu K, Kauff N, Powell CB et al (2009) ACOG Practice Bulletin: hereditary breast and ovarian cancer syndrome. Obstet Gynecol 113:957–966

    Google Scholar 

  26. American Society of Clinical Oncology, “Clinical Practice Guidelines,” November 2010. http://www.asco.org. Accessed 12 Dec 2010

  27. National Comprehensive Cancer Network, “Genetic/Familial High-Risk Assessment: Breast and Ovarian,” November 2010. http://www.nccn.org. Accessed 12 Dec 2010

  28. ClinicalTrial.gov. November 2010. www.clinicaltrials.gov/ct2/show/NCT01102569. Accessed 12 Dec 2010

  29. Offit K, Levran O, Mullaney B et al (2003) Shared genetic susceptibility to breast cancer, brain tumors, and Fanconi anemia. J Natl Cancer Inst 95:1548–1551

    PubMed  CAS  Google Scholar 

  30. Thompson D, Easton DF (2002) Cancer incidence in BRCA1 Mutation Carriers. J Natl Cancer Inst 94:1358–1365

    PubMed  CAS  Google Scholar 

  31. Levine DA, Argenta PA, Yee CJ et al (2003) Fallopian tube and primary peritoneal carcinomas associated with BRCA mutations. J Clin Oncol 21:4222–4227

    Article  PubMed  CAS  Google Scholar 

  32. Abeloff MD, Armitage JO, Niederhuber JE et al (2008) Abeloff’s clinical oncology, 4th edn. Churchill Livingstone Elsevier, PA

    Google Scholar 

  33. Devita VT Jr, Hellman S, Rosenberg SA et al (2008) Cancer principle and practice of oncology, 8th edn. Lippincott Williams and Wilkins, PA

    Google Scholar 

  34. The Breast Cancer Linkage Consortium (1999) Cancer risks in BRCA2 mutation carriers. J Natl Cancer Inst 91:1310–1316

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ann Marie Augustyn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Augustyn, A.M., Agostino, N.M., Namey, T.L. et al. Two patients with germline mutations in both BRCA1 and BRCA2 discovered unintentionally: a case series and discussion of BRCA testing modalities. Breast Cancer Res Treat 129, 629–634 (2011). https://doi.org/10.1007/s10549-011-1597-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-011-1597-9

Keywords

Navigation