Abstract
BackgroundGermline mutations in the BRIP1 gene have been described as conferring a moderate risk for ovarian cancer (OC), while the role of BRIP1 in breast cancer (BC) pathogenesis remains controversial.MethodsTo assess the role of deleterious BRIP1 germline mutations in BC/OC predisposition, 6341 well-characterized index patients with BC, 706 index patients with OC, and 2189 geographically matched female controls were screened for loss-of-function (LoF) mutations and potentially damaging missense variants. All index patients met the inclusion criteria of the German Consortium for Hereditary Breast and Ovarian Cancer for germline testing and tested negative for pathogenic BRCA1/2 variants.ResultsBRIP1 LoF mutations confer a high OC risk in familial index patients (odds ratio (OR) = 20.97, 95% confidence interval (CI) = 12.02–36.57, P < 0.0001) and in the subgroup of index patients with late-onset OC (OR = 29.91, 95% CI = 14.99–59.66, P < 0.0001). No significant association of BRIP1 LoF mutations with familial BC was observed (OR = 1.81 95% CI = 1.00–3.30, P = 0.0623). In the subgroup of familial BC index patients without a family history of OC there was also no apparent association (OR = 1.42, 95% CI = 0.70–2.90, P = 0.3030). In 1027 familial BC index patients with a family history of OC, the BRIP1 mutation prevalence was significantly higher than that observed in controls (OR = 3.59, 95% CI = 1.43–9.01; P = 0.0168). Based on the negative association between BRIP1 LoF mutations and familial BC in the absence of an OC family history, we conclude that the elevated mutation prevalence in the latter cohort was driven by the occurrence of OC in these families. Compared with controls, predicted damaging rare missense variants were significantly more prevalent in OC (P = 0.0014) but not in BC (P = 0.0693) patients.ConclusionsTo avoid ambiguous results, studies aimed at assessing the impact of candidate predisposition gene mutations on BC risk might differentiate between BC index patients with an OC family history and those without. In familial cases, we suggest that BRIP1 is a high-risk gene for late-onset OC but not a BC predisposition gene, though minor effects cannot be excluded.
Highlights
Germline mutations in the BRIP1 gene have been described as conferring a moderate risk for ovarian cancer (OC), while the role of BRIP1 in breast cancer (BC) pathogenesis remains controversial
We suggest that the elevated BRIP1 mutation prevalence described in some studies with the focus on familial BC might be due to the co-occurrence of OC in these families, one generally used criterion to define a positive cancer family history
The highly significant associations shown in our study suggest that BRIP1 represents a high-risk gene for late-onset OC, further supporting the notion that risk-reducing salpingo-oophorectomy (RRSO) should be considered for BRIP1 mutation carriers
Summary
Germline mutations in the BRIP1 gene have been described as conferring a moderate risk for ovarian cancer (OC), while the role of BRIP1 in breast cancer (BC) pathogenesis remains controversial. Monoallelic germline mutations in known predisposition genes, including BRCA1 (OMIM 113705) and BRCA2 (OMIM 600185), explain less than half of all cases of familial breast cancer (BC) and/or ovarian cancer (OC), and confer moderate to high risk [1,2,3,4,5,6]. Germline mutations in the BRIP1 (BRCA1interacting protein C-terminal helicase 1) gene (OMIM 605882) have been reported to confer a moderate risk for OC, especially the high-grade serous epithelial subtype [6,7,8,9,10], and prophylactic surgery is increasingly considered for BRIP1 mutation carriers [11]. The impact of germline BRIP1 mutations on BC risk, remains controversial
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