Abstract

Approximately 10% of all breast cancer (BC) cases are familial and caused by inheritance of mutant BRCA1, BRCA2, or some other genes from the same DNA reparation pathway. Genetic counseling in families with cancer history is a powerful means for early cancer detection and active risk reduction through preventive interventions. This is the first report of the rare inherited BRCA2 frameshift-deletion mutation c.3847_3848delGT in one Lithuanian pedigree with the intense familial history of BC. Three BRCA2-positive blood relatives with BC of different biological types were identified in this pedigree with the same type mutation. All three cases were diagnosed with advanced stage ductal carcinoma. Markedly, polymorphic cells and numerous mitoses were identified in BC from the cases. Two patients from the family were diagnosed with the triple negative tumors, while one case had early onset of the hormone positive BC. Despite the variation in clinical and biological presentation of BC, all cases showed a good response to conventional treatment. In conclusion, the strong influence of BRCA2 mutation on the onset of BC of various biological types reveals the complexity of genetic counselling in families with BC history.

Highlights

  • Breast cancer (BC) is the most commonly diagnosed malignancy and leading cause of cancer death among women in the world [1]

  • Despite variation in biological subtype, histology, and onset of the disease in the described family, the response to neoadjuvant and adjuvant treatment was quite good, and that is in agreement with the published data on hereditary breast cancer (BC) [4]

  • A period of seven years passed until the disease progression was reported both for the hormone receptor-positive as well as for the triple negative breast cancer (TNBC) case of the pedigree

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Summary

Introduction

Breast cancer (BC) is the most commonly diagnosed malignancy and leading cause of cancer death among women in the world [1]. About two million new BC cases are diagnosed each year worldwide. 10% of all BC cases are heritable and caused by a germline DNA damage response gene mutation, mainly of the BRCA1 or the BRCA2 genes. BRCA1 mutation carriers possess a 55–65% average cumulative risk of breast cancer by age 70, and the risk for BRCA2 mutation carriers is slightly lower—45–55%. The 10-year risk of developing ovarian cancer has been reported to be 12.7% and 6.8%

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