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Krivokuca A, Mihajlovic M, Susnjar S, Spasojevic IB, Minic I, Popovic L, Brankovic-Magic M. Mutational profile of hereditary breast and ovarian cancer - Establishing genetic testing guidelines in a developing country. Curr Probl Cancer 2021; 46:100767. [PMID: 34284872 DOI: 10.1016/j.currproblcancer.2021.100767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 05/16/2021] [Accepted: 06/15/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Because many countries lack the capacity to follow the international guidelines for genetic testing, we suggest the specific approach for establishing local genetic testing guidelines that could be applied in developing countries. We focus on hereditary breast (BC) and ovarian cancer (OC) in Serbia. METHODS From the cohort of 550 persons who were referred for genetic counseling at the Institute for Oncology and Radiology of Serbia, 392 were selected. Personal and family histories were collected and germline DNA was sequenced with NGS in a panel of 20 genes. RESULTS Pathogenic (PV) and likely-pathogenic variants (LPV) were detected in 8 genes with the frequency of 23.7%. The most frequent were in BRCA1(7.6%), BRCA2(4.8%), PALB2(4.1%) and CHEK2(3.8%). They were also detected in ATM(1.8%), NBN(0.8%), TP53(0.5%) and RAD51C(0.3%). Whereas high carrier probability (CP), bilateral BC, BC and OC in the same patient and family history (FH) of BC/OC, were the strongest predictors for BRCA1/2 PV/LPV, lower CP values and early age of BC onset without FH were associated with higher frequency of PALB2 and CHEK2 PV/LPV. CONCLUSIONS Population specific studies to identify specific mutational patterns and predictors of PV/LPV should be conducted in order to make scientifically sound and cost-effective guidelines for genetic testing in developing countries.
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Affiliation(s)
- Ana Krivokuca
- Department for genetic counseling for hereditary cancers, Institute for Oncology and radiology of Serbia, Belgrade.
| | - Milica Mihajlovic
- Department for genetic counseling for hereditary cancers, Institute for Oncology and radiology of Serbia, Belgrade
| | - Snezana Susnjar
- Medical Oncology Department, Institute of Oncology and Radiology of Serbia, Belgrade
| | | | - Ivana Minic
- Medical Oncology Department, Institute of Oncology and Radiology of Serbia, Belgrade
| | - Lazar Popovic
- Medical Oncology Department, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Mirjana Brankovic-Magic
- Department for genetic counseling for hereditary cancers, Institute for Oncology and radiology of Serbia, Belgrade
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Darooei M, Poornima S, Salma BU, Iyer GR, Pujar AN, Annapurna S, Shah A, Maddali S, Hasan Q. Pedigree and BRCA gene analysis in breast cancer patients to identify hereditary breast and ovarian cancer syndrome to prevent morbidity and mortality of disease in Indian population. Tumour Biol 2017; 39:1010428317694303. [PMID: 28231738 DOI: 10.1177/1010428317694303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Global burden of breast cancer is expected to increase to >2 million new cases every year by 2030 and 10% of these are likely to have hereditary breast and ovarian cancer syndrome. Identifying these individuals by pedigree and BRCA1/2 mutation analyses will enable us to offer targeted mutation testing and appropriate counseling. This study from a tertiary care hospital showed that of the 127 breast cancer patients on treatment during 2014-2015, 24 of them fulfilled the criteria of hereditary breast and ovarian cancer syndrome after detailed verbal autopsy and pedigree analysis, and BRCA1 and 2 next-generation sequencing done after pre-test counseling revealed mutations in 13 cases (54%), these included 9 BRCA1 mutations (69%) and 4 BRCA2 mutation (31%). Subsequent post-test counseling recommended targeted mutation analysis for 64 high-risk members in these 13 families with pathogenic mutations, which will help in surveillance for early detection, appropriate management, and prevention of the disease by decreasing the burden to both family and nation. Results from this preliminary study highlight the importance of genetic counseling, pedigree analysis, and genetic testing. It can be recommended that all oncology units should have a genetic counseling service for providing appropriate support to oncologists, patients, and families to prevent unnecessary testing; however, breast cancer screening program is incomplete without evaluating for hereditary breast and ovarian cancer syndrome.
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Affiliation(s)
- Mina Darooei
- 1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India
| | - Subhadra Poornima
- 1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India
| | - Bibi Umae Salma
- 1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India
| | - Gayatri R Iyer
- 1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India
| | - Akhilesh N Pujar
- 1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India
| | - Srirambhatla Annapurna
- 2 Department of Radiology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, India
| | - Ashwin Shah
- 3 Department of Oncology, Kamineni Hospitals, Hyderabad, India
| | | | - Qurratulain Hasan
- 1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India
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Dodova RI, Mitkova AV, Dacheva DR, Hadjo LB, Vlahova AI, -Hadjieva MST, Valev SS, Caulevska MM, Popova SD, Popov IE, Dikov TI, Sedloev TA, Ionkov AS, Timcheva KV, Christova SL, Kremensky IM, Mitev VI, Kaneva RP. Spectrum and frequencies of BRCA1/2 mutations in Bulgarian high risk breast cancer patients. BMC Cancer 2015; 15:523. [PMID: 26183948 PMCID: PMC4504066 DOI: 10.1186/s12885-015-1516-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/26/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND About 3885 women are diagnosed with breast cancer and 1285 die from the disease each year in Bulgaria. However no genetic testing to identify the mutations in high-risk families has been provided so far. METHODS We evaluated 200 Bulgarian women with primary invasive breast cancer and with personal/ family history of breast cancer for the presence of unequivocally damaging germline mutations in BRCA1/2 using Sanger sequencing. RESULTS Of the 200 patients, 39 (19.5 %) carried a disease predisposing mutation, including 28 (14 %) with a BRCA1 mutation and 11 (5.5 %) with a BRCA2 mutation. At BRCA1, 6 different mutations were identified, including 2 frameshifts, 1 nonsense and 1 missense that had been previously reported (c.5030_5033delCTAA, c.5263_5264insC, c.4603G > T, c.181 T > G), and 2 frameshifts, which were novel to this study (c.464delA, c.5397_5403delCCCTTGG). At BRCA2, 7 different frameshift mutations were identified, including 5 previously reported (5851_5854delAGTT, c.5946delT, c.5718_5719delCT, c.7910_7914delCCTTT,c.9098_9099insA) and 2 novel (c.8532_8533delAA, c.9682delA). A BRCA1 mutation was found in 18.4 % of women diagnosed with breast cancer at/or under the age of 40 compared to 11.2 % of women diagnosed at a later age; a BRCA2 mutation was found in 4 % of women diagnosed at/or under the age of 40 compared to 6.5 % of women diagnosed at a later age. A mutation was present in 26.8 % patients with a positive family history and in 14.4 % of women with a negative family history. The most prevalent mutation observed in 22 patients (11 %) was BRCA1 c.5263_5264insC, a known Slavic mutation with founder effect in Eastern European and AJ communities. Other recurrent mutations were BRCA2 c.9098-9099insA (2 %), BRCA1 c.181T > G (1 %) and BRCA2 c.5851_5854delAGTT (1 %). Notably, BRCA1 c.5263_5264insC represented 56 % of all mutations identified in this series. Of the 22 patients with BRCA1 c.5263_5264insC, 9 were diagnosed with early onset breast cancer, 11 with TNBCs, 4 with bilateral breast cancer, and 6 with both breast and ovarian cancer. CONCLUSIONS This is the first comprehensive study of the BRCA1/2 mutation spectrum in Bulgaria and will assist the establishment of efficient protocols for genetic testing and individualized risk assessment for Bulgarian breast/ovarian cancer patients and healthy individuals at a high-risk.
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Affiliation(s)
- Rumyana Ivanova Dodova
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria.,Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | - Atanaska Velichkova Mitkova
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria. .,Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria.
| | - Daniela Rosenova Dacheva
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria.,Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | - Lina Basam Hadjo
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | - Alexandrina Ivanova Vlahova
- General and Clinical Pathology Clinic, University Hospital "Alexandrovska", 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria.,Department of General and Clinical Pathology, Medical University of Sofia, 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria
| | | | - Spartak Stoyanov Valev
- Clinic of Medical Oncology (Chemotherapy), Specialized Hospital for Active Treatment in Oncology, 6 "Plovdivsko pole" str., 1756, Sofia, Bulgaria
| | - Marija Mitko Caulevska
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | | | - Ivan Emilov Popov
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria.,Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | - Tihomir Iliichev Dikov
- General and Clinical Pathology Clinic, University Hospital "Alexandrovska", 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria.,Department of General and Clinical Pathology, Medical University of Sofia, 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria
| | - Theophil Angelov Sedloev
- Department of Surgery, University Hospital "Tsaritsa Yoana - ISUL", 8 "Byalo more" str., 1527, Sofia, Bulgaria.,Medical Faculty, 8 "Byalo more" str., 1527, Sofia, Bulgaria
| | - Atanas Stefanov Ionkov
- Department of General and Liver-Pancreatic Surgery, University Hospital "Alexandrovska", 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria.,Medical Faculty, Medical University of Sofia, 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria
| | - Konstanta Velinova Timcheva
- Clinic of Medical Oncology (Chemotherapy), Specialized Hospital for Active Treatment in Oncology, 6 "Plovdivsko pole" str., 1756, Sofia, Bulgaria
| | - Svetlana Liubomirova Christova
- General and Clinical Pathology Clinic, University Hospital "Alexandrovska", 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria.,Department of General and Clinical Pathology, Medical University of Sofia, 1 Georgi Sofiiski str., 1431, Sofia, Bulgaria
| | - Ivo Marinov Kremensky
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | - Vanio Ivanov Mitev
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria.,Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
| | - Radka Petrova Kaneva
- Molecular Medicine Center, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria.,Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University of Sofia, 2 Zdrave str., 1431, Sofia, Bulgaria
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