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Gelormini F, Vallino V, Breazzano MP, Pasini B, Reibaldi M, Borrelli E. Multimodal Imaging of a novel MFSD8/CLN7 mutation associated with non-syndromic symmetric adult-onset macular dystrophy. Retin Cases Brief Rep 2024:01271216-990000000-00288. [PMID: 38412107 DOI: 10.1097/icb.0000000000001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE To report multimodal imaging features of a novel MFSD8/CLN7 pathogenic variant associated with bilateral and symmetric non-syndromic macular dystrophy. METHODS A 63-year-old female patient presented complaining of a gradual subjective decline in visual acuity in both eyes over the previous months. This patient underwent a comprehensive ophthalmological assessment, including multimodal retinal imaging and electrophysiological testing. Given suspicion for a hereditary retinal disorder, genetic testing was pursued. RESULTS The eye examination revealed blunted foveal reflexes and no lesions or abnormalities in the equatorial or anterior retinal periphery. Multimodal imaging showed a bilateral and almost symmetrical subfoveal interruption of the outer retinal layers including an optical gap. Genetic testing revealed that the MFSD8/CLN7 gene exhibited a homozygous variant, specifically p.Ala484Val (c.1451C>T). This variant was identified as the likely causative factor for the condition. CONCLUSION We herein describe the clinical findings of a previously unreported homozygous variant in the MFSD8/CLN7 gene, resulting in a non-syndromic form of bilateral central macular dystrophy.
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Affiliation(s)
- Francesco Gelormini
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Veronica Vallino
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Mark P Breazzano
- Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Retina-Vitreous Surgeons of Central New York, Liverpool, NY, USA
- Department of Ophthalmology and Visual Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Barbara Pasini
- Unit of Medical Genetics, Department of Medical Sciences, University of Turin, Italy
| | - Michele Reibaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
| | - Enrico Borrelli
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Ophthalmology, "City of Health and Science" Hospital, Turin, Italy
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2
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Smirne C, Giacomini GM, Berton AM, Pasini B, Mercalli F, Prodam F, Caputo M, Brosens LAA, Mollero ELM, Pitino R, Pirisi M, Aimaretti G, Ghigo E. A novel likely pathogenetic variant p.(Cys235Arg) of the MEN1 gene in multiple endocrine neoplasia type 1 with multifocal glucagonomas. J Endocrinol Invest 2024:10.1007/s40618-023-02287-x. [PMID: 38294658 DOI: 10.1007/s40618-023-02287-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/17/2023] [Indexed: 02/01/2024]
Abstract
PURPOSE Multiple endocrine neoplasia type 1 (MEN1) is a hereditary endocrine syndrome caused by pathogenic variants in MEN1 tumor suppressor gene. Diagnosis is commonly based on clinical criteria and confirmed by genetic testing. The objective of the present study was to report on a MEN1 case characterized by multiple pancreatic glucagonomas, with particular concern on the possible predisposing genetic defects. METHODS While conducting an extensive review of the most recent scientific evidence on the unusual glucagonoma familial forms, we analyzed the MEN1 gene in a 35-year-old female with MEN1, as well as her son and daughter, using Sanger and next-generation sequencing (NGS) approaches. We additionally explored the functional and structural consequences of the identified variant using in silico analyses. RESULTS NGS did not show any known pathogenic variant in the tested regions. However, a new non-conservative variant in exon 4 of MEN1 gene was found in heterozygosity in the patient and in her daughter, resulting in an amino acid substitution from hydrophobic cysteine to hydrophilic arginine at c.703T > C, p.(Cys235Arg). This variant is absent from populations databases and was never reported in full papers: its characteristics, together with the high specificity of the patient's clinical phenotype, pointed toward a possible causative role. CONCLUSION Our findings confirm the need for careful genetic analysis of patients with MEN1 and establish a likely pathogenic role for the new p.(Cys235Arg) variant, at least in the rare subset of MEN1 associated with glucagonomas.
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Affiliation(s)
- C Smirne
- Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy.
- Division of Internal Medicine, University Hospital Maggiore della Carità, 28100, Novara, Italy.
| | - G M Giacomini
- Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
- Division of Internal Medicine, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - A M Berton
- Division of Endocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, 10126, Turin, Italy
| | - B Pasini
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
- Division of Medical Genetics, City of Health and Science University Hospital, 10126, Turin, Italy
| | - F Mercalli
- Division of Pathology, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - F Prodam
- Department of Health Sciences, University of Piemonte Orientale, 28100, Novara, Italy
- Division of Endocrinology, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - M Caputo
- Department of Health Sciences, University of Piemonte Orientale, 28100, Novara, Italy
- Division of Endocrinology, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - L A A Brosens
- Department of Pathology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - E L M Mollero
- Division of Endocrinology, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - R Pitino
- Division of Endocrinology, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - M Pirisi
- Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
- Division of Internal Medicine, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - G Aimaretti
- Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100, Novara, Italy
- Division of Endocrinology, University Hospital Maggiore della Carità, 28100, Novara, Italy
| | - E Ghigo
- Division of Endocrinology, Diabetes and Metabolism, City of Health and Science University Hospital, 10126, Turin, Italy
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
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3
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Pagliara D, Ciolfi A, Pedace L, Haghshenas S, Ferilli M, Levy MA, Miele E, Nardini C, Cappelletti C, Relator R, Pitisci A, De Vito R, Pizzi S, Kerkhof J, McConkey H, Nazio F, Kant SG, Di Donato M, Agolini E, Matraxia M, Pasini B, Pelle A, Galluccio T, Novelli A, Barakat TS, Andreani M, Rossi F, Mecucci C, Savoia A, Sadikovic B, Locatelli F, Tartaglia M. Identification of a robust DNA methylation signature for Fanconi anemia. Am J Hum Genet 2023; 110:1938-1949. [PMID: 37865086 PMCID: PMC10645556 DOI: 10.1016/j.ajhg.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/23/2023] Open
Abstract
Fanconi anemia (FA) is a clinically variable and genetically heterogeneous cancer-predisposing disorder representing the most common bone marrow failure syndrome. It is caused by inactivating predominantly biallelic mutations involving >20 genes encoding proteins with roles in the FA/BRCA DNA repair pathway. Molecular diagnosis of FA is challenging due to the wide spectrum of the contributing gene mutations and structural rearrangements. The assessment of chromosomal fragility after exposure to DNA cross-linking agents is generally required to definitively confirm diagnosis. We assessed peripheral blood genome-wide DNA methylation (DNAm) profiles in 25 subjects with molecularly confirmed clinical diagnosis of FA (FANCA complementation group) using Illumina's Infinium EPIC array. We identified 82 differentially methylated CpG sites that allow to distinguish subjects with FA from healthy individuals and subjects with other genetic disorders, defining an FA-specific DNAm signature. The episignature was validated using a second cohort of subjects with FA involving different complementation groups, documenting broader genetic sensitivity and demonstrating its specificity using the EpiSign Knowledge Database. The episignature properly classified DNA samples obtained from bone marrow aspirates, demonstrating robustness. Using the selected probes, we trained a machine-learning model able to classify EPIC DNAm profiles in molecularly unsolved cases. Finally, we show that the generated episignature includes CpG sites that do not undergo functional selective pressure, allowing diagnosis of FA in individuals with reverted phenotype due to gene conversion. These findings provide a tool to accelerate diagnostic testing in FA and broaden the clinical utility of DNAm profiling in the diagnostic setting.
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Affiliation(s)
- Daria Pagliara
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Andrea Ciolfi
- Molecular Genetics and Functional Genomics, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Lucia Pedace
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Sadegheh Haghshenas
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Marco Ferilli
- Molecular Genetics and Functional Genomics, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Michael A Levy
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Evelina Miele
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Claudia Nardini
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Camilla Cappelletti
- Molecular Genetics and Functional Genomics, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Raissa Relator
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Angela Pitisci
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Rita De Vito
- Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Simone Pizzi
- Molecular Genetics and Functional Genomics, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Jennifer Kerkhof
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Haley McConkey
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada; Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
| | - Francesca Nazio
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy
| | - Sarina G Kant
- Department of Clinical Genetics, Erasmus MC University Medical Center, 3015 Rotterdam, the Netherlands
| | - Maddalena Di Donato
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, IRCCS, 00146 Rome, Italy
| | - Emanuele Agolini
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, IRCCS, 00146 Rome, Italy
| | - Marta Matraxia
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, IRCCS, 00146 Rome, Italy
| | - Barbara Pasini
- AOU Città della salute e della scienza di Torino, Molinette's Hospital, 10126 Torino, Italy
| | - Alessandra Pelle
- AOU Città della salute e della scienza di Torino, Molinette's Hospital, 10126 Torino, Italy
| | - Tiziana Galluccio
- Laboratory of Transplant Immunogenetics, Department of Hematology/Oncology, Cell and Gene Therapy, IRCCS Bambino Gesù Children's Hospital, 00146 Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, IRCCS, 00146 Rome, Italy
| | - Tahsin Stefan Barakat
- Department of Clinical Genetics, Erasmus MC University Medical Center, 3015 Rotterdam, the Netherlands; ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus MC University Medical Center, 3015 Rotterdam, the Netherlands
| | - Marco Andreani
- Laboratory of Transplant Immunogenetics, Department of Hematology/Oncology, Cell and Gene Therapy, IRCCS Bambino Gesù Children's Hospital, 00146 Rome, Italy
| | - Francesca Rossi
- Department of Woman, Child and of General and Specialist Surgery, University of Campania "Luigi Vanvitelli," 80138 Naples, Italy
| | - Cristina Mecucci
- Institute of Hematology and Center for Hemato-Oncology Research, University and Hospital of Perugia, 06123 Perugia, Italy
| | - Anna Savoia
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Bekim Sadikovic
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON N6A 5W9, Canada; Department of Pathology and Laboratory Medicine, Western University, London, ON N6A 3K7, Canada
| | - Franco Locatelli
- Department of Hematology/Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy; Department of Pediatrics, Catholic University of the Sacred Hearth, 00168 Rome, Italy.
| | - Marco Tartaglia
- Molecular Genetics and Functional Genomics, Bambino Gesù Children's Hospital, IRCCS, 00146 Rome, Italy.
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4
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Giovenino C, Trajkova S, Pavinato L, Cardaropoli S, Pullano V, Ferrero E, Sukarova-Angelovska E, Carestiato S, Salmin P, Rinninella A, Battaglia A, Bertoli L, Fadda A, Palermo F, Carli D, Mussa A, Dimartino P, Bruselles A, Froukh T, Mandrile G, Pasini B, De Rubeis S, Buxbaum JD, Pippucci T, Tartaglia M, Rossato M, Delledonne M, Ferrero GB, Brusco A. Skewed X-chromosome inactivation in unsolved neurodevelopmental disease cases can guide re-evaluation For X-linked genes. Eur J Hum Genet 2023; 31:1228-1236. [PMID: 36879111 PMCID: PMC10620389 DOI: 10.1038/s41431-023-01324-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/24/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
Despite major advances in genome technology and analysis, >50% of patients with a neurodevelopmental disorder (NDD) remain undiagnosed after extensive evaluation. A point in case is our clinically heterogeneous cohort of NDD patients that remained undiagnosed after FRAXA testing, chromosomal microarray analysis and trio exome sequencing (ES). In this study, we explored the frequency of non-random X chromosome inactivation (XCI) in the mothers of male patients and affected females, the rationale being that skewed XCI might be masking previously discarded genetic variants found on the X chromosome. A multiplex fluorescent PCR-based assay was used to analyse the pattern of XCI after digestion with HhaI methylation-sensitive restriction enzyme. In families with skewed XCI, we re-evaluated trio-based ES and identified pathogenic variants and a deletion on the X chromosome. Linkage analysis and RT-PCR were used to further study the inactive X chromosome allele, and Xdrop long-DNA technology was used to define chromosome deletion boundaries. We found skewed XCI (>90%) in 16/186 (8.6%) mothers of NDD males and in 12/90 (13.3%) NDD females, far beyond the expected rate of XCI in the normal population (3.6%, OR = 4.10; OR = 2.51). By re-analyzing ES and clinical data, we solved 7/28 cases (25%) with skewed XCI, identifying variants in KDM5C, PDZD4, PHF6, TAF1, OTUD5 and ZMYM3, and a deletion in ATRX. We conclude that XCI profiling is a simple assay that targets a subgroup of patients that can benefit from re-evaluation of X-linked variants, thus improving the diagnostic yield in NDD patients and identifying new X-linked disorders.
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Affiliation(s)
- Chiara Giovenino
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Slavica Trajkova
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Lisa Pavinato
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Simona Cardaropoli
- Department of Public Health and Pediatrics, University of Turin, 10126, Turin, Italy
| | - Verdiana Pullano
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Enza Ferrero
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Elena Sukarova-Angelovska
- Department of Endocrinology and Genetics, University Clinic for Pediatric Diseases, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 1000, Skopje, Republic of North Macedonia
| | - Silvia Carestiato
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Paola Salmin
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10126, Turin, Italy
| | - Antonina Rinninella
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, 94124, Catania, Italy
| | - Anthony Battaglia
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Luca Bertoli
- Functional Genomics Lab, Department of Biotechnology, University of Verona, 37134, Verona, Italy
| | - Antonio Fadda
- Functional Genomics Lab, Department of Biotechnology, University of Verona, 37134, Verona, Italy
| | - Flavia Palermo
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
| | - Diana Carli
- Department of Public Health and Pediatrics, University of Turin, 10126, Turin, Italy
| | - Alessandro Mussa
- Department of Public Health and Pediatrics, University of Turin, 10126, Turin, Italy
| | - Paola Dimartino
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Bruselles
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, 00146, Rome, Italy
| | - Tawfiq Froukh
- Department of Biotechnology and Genetic Engineering, Philadelphia University, Amman, Jordan
| | - Giorgia Mandrile
- Medical Genetics Unit and Thalassemia Center, San Luigi University Hospital, University of Torino, Orbassano, TO, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10126, Turin, Italy
| | - Silvia De Rubeis
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Tommaso Pippucci
- U.O. Genetica Medica, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, 00146, Rome, Italy
| | - Marzia Rossato
- Functional Genomics Lab, Department of Biotechnology, University of Verona, 37134, Verona, Italy
| | - Massimo Delledonne
- Functional Genomics Lab, Department of Biotechnology, University of Verona, 37134, Verona, Italy
| | | | - Alfredo Brusco
- Department of Medical Sciences, University of Turin, 10126, Turin, Italy.
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10126, Turin, Italy.
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5
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Gironi LC, Esposto E, Zottarelli F, Giorgione R, Farinelli P, Zavattaro E, Cammarata E, Di Cristo N, Ogliara P, Camillo L, Giordano M, Mellone S, Pasini B, Ambrosi A, Savoia P. Temporal correlation between the first melanoma and the first noncutaneous tumor in CKDN2A genotyped patients. Melanoma Res 2023; 33:425-430. [PMID: 37352544 DOI: 10.1097/cmr.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
CDKN2A pathogenic variants are well known to be associated with cutaneous melanoma and noncutaneous tumors (NCTs). Herein, we investigated the temporal correlation between the first cutaneous melanoma and NCT both in CDKN2A mutation carriers (MUT) and in wild-type melanoma patients, a poorly explored issue to date. Two hundred forty-five cutaneous melanoma patients were genotyped for the CDKN2A gene and divided into 51 MUT and 189 wild-type; the remaining five variant carriers were excluded from the analyses. MUT developed a significantly higher number of cutaneous melanoma than wild-type, while 13.7% in both genotyped groups received a diagnosis of at least one malignant NCT, without statistically significant differences. The onset of the first cutaneous melanoma preceded that of the first malignant or benign NCT in both MUT and wild-type patients by an average of 4.5 and 3.02 years, respectively. Considering only malignant tumors, the diagnosis of melanoma preceded that of the first NCT on an average of 8 and 4.34 years, in MUT and wild-type patients respectively. We emphasize the relevance to adopt a global vision for the primary and secondary surveillance of patients affected by cutaneous melanoma, not only limited to high-risk for multiple primary skin cancers but also to NCT that may develop several years after the diagnosis of the first cutaneous melanoma.
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Affiliation(s)
| | | | | | | | | | - Elisa Zavattaro
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | | | - Nunzia Di Cristo
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | - Paola Ogliara
- Department of Medical Sciences, University of Turin, Turin
| | - Lara Camillo
- Department of Health Sciences, University of Eastern Piedmont, Novara
| | - Mara Giordano
- Department of Health Sciences, University of Eastern Piedmont, Novara
- SCDU of Clinical Biochemistry, Laboratory of Genetics, AOU Maggiore della Carità, Novara
| | - Simona Mellone
- SCDU of Clinical Biochemistry, Laboratory of Genetics, AOU Maggiore della Carità, Novara
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara
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6
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Persico I, Fiscarelli I, Pelle A, Faleschini M, Pasini B, Savoia A, Bottega R. Phenotype reversion as "natural gene therapy" in Fanconi anemia by a gene conversion event. Front Genet 2023; 14:1240758. [PMID: 37790699 PMCID: PMC10544911 DOI: 10.3389/fgene.2023.1240758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 10/05/2023] Open
Abstract
Somatic mosaicism appears as a recurrent phenomenon among patients suffering from Fanconi anemia (FA), but its direct prognostic significance mostly remains an open question. The clinical picture of FA mosaic subjects could indeed vary from just mild features to severe hematologic failure. Here, we illustrate the case of a proband whose FA familiarity, modest signs (absence of hematological anomalies and fertility issues), and chromosome fragility test transition to negative overtime were suggestive of somatic mosaicism. In line with this hypothesis, genetic testing on patient's peripheral blood and buccal swab reported the presence of the only FANCA paternal variant (FANCA:c.2638C>T, p. Arg880*) and of both parental alleles (the additional FANCA:c.3164G>A, p. Arg1055Gln), respectively. Moreover, the SNP analysis performed on the same biological specimens allowed us to attribute the proband's mosaicism status to a possible gene conversion mechanism. Our case clearly depicts the positive association between somatic mosaicism and the proband's favorable clinical course due to the occurrence of the reversion event at the hematopoietic stem cell level. Since this condition concerns only a limited subgroup of FA individuals, the accurate evaluation of the origin and extent of clonality would be key to steer clinicians toward the most appropriate therapeutic decision for their FA mosaic patients.
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Affiliation(s)
- Ilaria Persico
- Genomic Instability DNA Repair Syndromes Group, Joint Research Unit in Genomic Medicine UAB-IR Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Ilaria Fiscarelli
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, Torino, Italy
- SC Genetica Medica U, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessandra Pelle
- SC Genetica Medica U, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Michela Faleschini
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Barbara Pasini
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, Torino, Italy
- SC Genetica Medica U, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Anna Savoia
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Roberta Bottega
- Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
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Stolarova L, Kleiblova P, Zemankova P, Stastna B, Janatova M, Soukupova J, Achatz MI, Ambrosone C, Apostolou P, Arun BK, Auer P, Barnard M, Bertelsen B, Blok MJ, Boddicker N, Brunet J, Burnside ES, Calvello M, Campbell I, Chan SH, Chen F, Chiang JB, Coppa A, Cortesi L, Crujeiras-González A, De Leeneer K, De Putter R, DePersia A, Devereux L, Domchek S, Efremidis A, Engel C, Ernst C, Evans DGR, Feliubadaló L, Fostira F, Fuentes-Ríos O, Gómez-García EB, González S, Haiman C, Hansen TVO, Hauke J, Hodge J, Hu C, Huang H, Ishak NDB, Iwasaki Y, Konstantopoulou I, Kraft P, Lacey J, Lázaro C, Li N, Lim WK, Lindstrom S, Lori A, Martinez E, Martins A, Matsuda K, Matullo G, McInerny S, Michailidou K, Montagna M, Monteiro AN, Mori L, Nathanson K, Neuhausen SL, Nevanlinna H, Olson JE, Palmer J, Pasini B, Patel A, Piane M, Poppe B, Radice P, Renieri A, Resta N, Richardson ME, Rosseel T, Ruddy KJ, Santamariña M, Dos Santos ES, Teras L, Toland AE, Trentham-Dietz A, Vachon CM, Volk AE, Weber-Lassalle N, Weitzel JN, Wiesmuller L, Winham S, Yadav S, Yannoukakos D, Yao S, Zampiga V, Zethoven M, Zhang ZW, Zima T, Spurdle AB, Vega A, Rossing M, Del Valle J, De Nicolo A, Hahnen E, Claes KB, Ngeow J, Momozawa Y, James PA, Couch FJ, Macurek L, Kleibl Z. ENIGMA CHEK2gether Project: A Comprehensive Study Identifies Functionally Impaired CHEK2 Germline Missense Variants Associated with Increased Breast Cancer Risk. Clin Cancer Res 2023; 29:3037-3050. [PMID: 37449874 PMCID: PMC10425727 DOI: 10.1158/1078-0432.ccr-23-0212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/06/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Germline pathogenic variants in CHEK2 confer moderately elevated breast cancer risk (odds ratio, OR ∼ 2.5), qualifying carriers for enhanced breast cancer screening. Besides pathogenic variants, dozens of missense CHEK2 variants of uncertain significance (VUS) have been identified, hampering the clinical utility of germline genetic testing (GGT). EXPERIMENTAL DESIGN We collected 460 CHEK2 missense VUS identified by the ENIGMA consortium in 15 countries. Their functional characterization was performed using CHEK2-complementation assays quantifying KAP1 phosphorylation and CHK2 autophosphorylation in human RPE1-CHEK2-knockout cells. Concordant results in both functional assays were used to categorize CHEK2 VUS from 12 ENIGMA case-control datasets, including 73,048 female patients with breast cancer and 88,658 ethnicity-matched controls. RESULTS A total of 430/460 VUS were successfully analyzed, of which 340 (79.1%) were concordant in both functional assays and categorized as functionally impaired (N = 102), functionally intermediate (N = 12), or functionally wild-type (WT)-like (N = 226). We then examined their association with breast cancer risk in the case-control analysis. The OR and 95% CI (confidence intervals) for carriers of functionally impaired, intermediate, and WT-like variants were 2.83 (95% CI, 2.35-3.41), 1.57 (95% CI, 1.41-1.75), and 1.19 (95% CI, 1.08-1.31), respectively. The meta-analysis of population-specific datasets showed similar results. CONCLUSIONS We determined the functional consequences for the majority of CHEK2 missense VUS found in patients with breast cancer (3,660/4,436; 82.5%). Carriers of functionally impaired missense variants accounted for 0.5% of patients with breast cancer and were associated with a moderate risk similar to that of truncating CHEK2 variants. In contrast, 2.2% of all patients with breast cancer carried functionally wild-type/intermediate missense variants with no clinically relevant breast cancer risk in heterozygous carriers.
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Affiliation(s)
- Lenka Stolarova
- Laboratory of Cancer Cell Biology, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Petra Kleiblova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petra Zemankova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Department of Pathophysiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Barbora Stastna
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Marketa Janatova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Soukupova
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Maria Isabel Achatz
- A.C. Camargo Cancer Center and Oncology Center, Hospital Sirio-Libanes, Sao Paulo, Brazil
| | - Christine Ambrosone
- Department of Cancer Prevention & Control, Roswell Park Cancer Center, Buffalo, New York
- WCHS Inc., Baltimore, Maryland
| | - Paraskevi Apostolou
- Human Molecular Genetics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos," Athens, Greece
| | - Banu K. Arun
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paul Auer
- Division of Biostatistics, Institute for Health and Equity, and Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin
- WHI, USA
| | - Mollie Barnard
- Slone Epidemiology Center, Boston University, Boston, Massachusetts
| | - Birgitte Bertelsen
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marinus J. Blok
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nicholas Boddicker
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
- CARRIERS, USA
| | - Joan Brunet
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, L'Hospitalet, Barcelona, Spain
| | - Elizabeth S. Burnside
- School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
- WWHS, Charlotte, North Carolina
| | - Mariarosaria Calvello
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Ian Campbell
- Cancer Genomics Laboratory, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Sock Hoai Chan
- Cancer Genetics Service, National Cancer Centre, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Fei Chen
- Keck School of Medicine, University of Southern California, Los Angeles, California
- MEC, USA
| | - Jian Bang Chiang
- Cancer Genetics Service, National Cancer Centre, Singapore, Singapore
| | - Anna Coppa
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Cortesi
- Department of Oncology and Haematology, Modena University Hospital, Modena, Italy
| | - Ana Crujeiras-González
- Fundacion Publica Galega de Medicina Xenomica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Kim De Leeneer
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Robin De Putter
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Allison DePersia
- Center for Medical Genetics, NorthShore University Health System, Evanston, Illinois
| | - Lisa Devereux
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
- Lifepool, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Susan Domchek
- CARRIERS, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anna Efremidis
- Clinical Cancer Genetics and Family Consultants, CLINICAGENE, Athens Medical Center, Athens, Greece
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Corinna Ernst
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - D. Gareth R. Evans
- Manchester Centre for Genomic Medicine, Division of Evolution and Genomic Sciences, University of Manchester, Manchester, United Kingdom
| | - Lidia Feliubadaló
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, L'Hospitalet, Barcelona, Spain
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos," Athens, Greece
| | - Olivia Fuentes-Ríos
- Fundacion Publica Galega de Medicina Xenomica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Encarna B. Gómez-García
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Sara González
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, L'Hospitalet, Barcelona, Spain
| | - Christopher Haiman
- Keck School of Medicine, University of Southern California, Los Angeles, California
- MEC, USA
| | - Thomas van Overeem Hansen
- Department of Clinical Genetics, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Jan Hauke
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - James Hodge
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
- CPS3, Kennesaw, Georgia
| | - Chunling Hu
- CARRIERS, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Hongyan Huang
- T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts
- NHS, Reston, Virginia
| | | | - Yusuke Iwasaki
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos," Athens, Greece
| | - Peter Kraft
- T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts
- NHS, Reston, Virginia
| | - James Lacey
- Beckman Research Institute, City of Hope Cancer Center, Duarte, California
- CTS, USA
| | - Conxi Lázaro
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, L'Hospitalet, Barcelona, Spain
| | - Na Li
- Cancer Genomics Laboratory, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Sara Lindstrom
- WHI, USA
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Adriana Lori
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
- American Cancer Society, Atlanta, Georgia
| | - Elana Martinez
- Duke-NUS Medical School, Singapore, Singapore
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California
| | - Alexandra Martins
- Inserm UMR1245, UNIROUEN, Normandy Centre for Genomic and Personalized Medicine, Normandie University, Rouen, France
| | - Koichi Matsuda
- Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Giuseppe Matullo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone McInerny
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, and Royal Melbourne Hospital, Melbourne, Australia
| | - Kyriaki Michailidou
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, Padua, Italy
| | - Alvaro N.A. Monteiro
- Cancer Epidemiology Program, Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Luigi Mori
- Endocrine and Metabolic Disease Unit, ASST Spedali Civili of Brescia, Brescia, Italia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Katherine Nathanson
- CARRIERS, USA
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Susan L. Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Janet E. Olson
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
- MCBCS, USA
| | - Julie Palmer
- Slone Epidemiology Center, Boston University, Boston, Massachusetts
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alpa Patel
- Department of Population Science, American Cancer Society, Atlanta, Georgia
- CPS-II, USA
| | - Maria Piane
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Bruce Poppe
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Paolo Radice
- Department of Experimental Oncology, Molecular Bases of Genetic Risk and Genetic Testing Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Nicoletta Resta
- Department of Precision and Regenerative Medicine and Ionian Area, Medical Genetics Unit, University of Bari, Bari, Italy
| | | | - Toon Rosseel
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Kathryn J. Ruddy
- MCBCS, USA
- Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - Marta Santamariña
- Fundacion Publica Galega de Medicina Xenomica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Santiago de Compostela, Spain
| | | | - Lauren Teras
- Department of Population Science, American Cancer Society, Atlanta, Georgia
- CPS-II, USA
| | - Amanda E. Toland
- Department of Cancer Biology & Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Amy Trentham-Dietz
- WWHS, Charlotte, North Carolina
- University of Wisconsin, Madison, Wisconsin
| | | | - Alexander E. Volk
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nana Weber-Lassalle
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | - Lisa Wiesmuller
- Department of Obstetrics and Gynecology, Ulm University, Ulm, Germany
| | - Stacey Winham
- MMHS, USA
- Department Quantitative Sciences, Mayo Clinic, Rochester, Minnesota
| | - Siddhartha Yadav
- CARRIERS, USA
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRaSTES, National Center for Scientific Research "Demokritos," Athens, Greece
| | - Song Yao
- WCHS Inc., Baltimore, Maryland
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Valentina Zampiga
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori," Meldola, Italy
| | - Magnus Zethoven
- Cancer Genomics Laboratory, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Ze Wen Zhang
- Cancer Genetics Service, National Cancer Centre, Singapore, Singapore
| | - Tomas Zima
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Amanda B. Spurdle
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Ana Vega
- Fundacion Publica Galega de Medicina Xenomica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Santiago de Compostela, Spain
| | - Maria Rossing
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jesús Del Valle
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IGTP-IDIBGI, L'Hospitalet, Barcelona, Spain
| | - Arcangela De Nicolo
- Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kathleen B.M. Claes
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Joanne Ngeow
- Cancer Genetics Service, National Cancer Centre, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Paul A. James
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
- Inserm UMR1245, UNIROUEN, Normandy Centre for Genomic and Personalized Medicine, Normandie University, Rouen, France
| | - Fergus J. Couch
- CARRIERS, USA
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
| | - Libor Macurek
- Laboratory of Cancer Cell Biology, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Zdenek Kleibl
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Department of Pathophysiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Zumstein L, Tuninetti V, Vaira M, Siatis D, Palermo F, Petracchini M, Scotto G, Turinetto M, Piva R, Pasini B, Valabrega G. Lynch syndrome-associated endometrial cancer patient with a rare novel germline likely pathogenic variant of MSH2 gene: A case report. Gynecol Oncol Rep 2023; 48:101220. [PMID: 37434947 PMCID: PMC10331303 DOI: 10.1016/j.gore.2023.101220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/24/2023] [Accepted: 06/04/2023] [Indexed: 07/13/2023] Open
Abstract
The Lynch syndrome (LS) is an autosomal dominant condition usually characterized by germline pathogenic variants in DNA mismatch repair (MMR) genes. Despite the guidelines now available, determining the pathogenicity of rare variants remains challenging, as the clinical significance of a genetic variant could be uncertain, but it may represent a disease-associated variation in the aforementioned genes. In this case report we will describe the case of a 47 years-old female affected by endometrial cancer (EC) with an extremely rare germline heterozygous variant in the MSH2 gene (c.562G > T p. (Glu188Ter), exon 3) that is likely pathogenic, and a family history consistent with LS.
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Affiliation(s)
- L. Zumstein
- Department of Oncology, University of Turin, Turin, Italy
| | - V. Tuninetti
- Department of Oncology, University of Turin, Medical Oncology, Ordine Mauriziano Hospital
| | - M. Vaira
- Department of Surgical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - D. Siatis
- Department of Surgical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - F. Palermo
- Department of Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - M. Petracchini
- Department of Radiology, Umberto I Mauriziano Hospital, Turin, Italy
| | - G. Scotto
- Department of Oncology, University of Turin, Turin, Italy
| | - M. Turinetto
- Department of Oncology, University of Turin, Turin, Italy
| | - R. Piva
- Department of Molecular Biotechnology and Health Sciences, University of Turin, 10126 Turin, Italy
- Città Della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - B. Pasini
- Medical Genetics Unit at the AOU Città della Salute e della Scienza di Torino, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - G. Valabrega
- Department of Oncology, University of Turin, Medical Oncology, Ordine Mauriziano Hospital
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Roccuzzo G, Giordano S, Granato T, Cavallo F, Mastorino L, Avallone G, Pasini B, Quaglino P, Ribero S. Phenotypic and Dermoscopic Patterns of Familial Melanocytic Lesions: A Pilot Study in a Third-Level Center. Cancers (Basel) 2023; 15:3772. [PMID: 37568588 PMCID: PMC10416987 DOI: 10.3390/cancers15153772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Cutaneous melanoma is a highly aggressive skin cancer. It is estimated that 5% to 10% of the underlying mutations are hereditary and responsible for familial (or hereditary) melanoma. These patients are prone to the early development and higher risk of multiple melanomas. In recent years, an increasing number of genes have been identified thanks to genetic testing, allowing the subsequent surveillance of individuals at risk, yet it is still difficult to predict the presence of these mutations on a clinical basis. In this scenario, specific phenotypic and dermoscopic features could help clinicians in their identification. The aim of this work has been to correlate mutations to prevalent dermoscopic patterns, paving the way for reference models useful in clinical practice. In our cohort, out of 115 patients referred to genetic counseling for melanoma, 25 tested positive (21.7%) for critical mutations: CDKN2A (n = 12), MITF (n = 3), BAP1 (n = 1), MC1R (n = 3), PTEN (n = 1), TYR (n = 2), OCA2 (n = 1), and SLC45A2 (n = 2). The phenotype profiles obtained through the digital acquisition, analysis, and description of both benign and malignant pigmented lesions showed a predominance of the type II skin phenotype, with an elevated mean total nevus number (182 moles, range 75-390). As for dermoscopic features, specific mutation-related patterns were described in terms of pigmentation, areas of regression, and vascular structures. Although further studies with larger cohorts are needed, our work represents the beginning of a new approach to the study and diagnosis of familial melanoma, underlining the importance of clinical and dermoscopic patterns, which may constitute a reference model for each gene, enabling comparison.
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Affiliation(s)
- Gabriele Roccuzzo
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Silvia Giordano
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Thomas Granato
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Francesco Cavallo
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Luca Mastorino
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Gianluca Avallone
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Barbara Pasini
- Medical Genetics Unit, AOU ‘Città Della Salute e Della Scienza’-‘Molinette’ Hospital, 10126 Turin, Italy;
| | - Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
| | - Simone Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, 10126 Turin, Italy
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Roveta F, Marcinnò A, Grassini A, Ferrandes F, Cermelli A, Boschi S, Gallone S, Atzori C, Imperiale D, Dentelli P, Pasini B, Brusco A, Rubino E, Rainero I. A Novel PSEN1 Variant Leading to Posterior Cortical Atrophy: A Case Report. J Alzheimers Dis Rep 2023; 7:469-473. [PMID: 37313494 PMCID: PMC10259045 DOI: 10.3233/adr230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/21/2023] [Indexed: 06/15/2023] Open
Abstract
We describe a 52-year-old patient with a progressive visuospatial disorder and apraxia. Neuropsychological assessment, neuroradiological findings, and Alzheimer's disease (AD) core biomarker assay on cerebrospinal fluid led to a diagnosis of posterior cortical atrophy due to AD. We performed a next generation sequencing dementia-gene panel and found the c.1301 C>T p.(Ala434Val) variant in the Presenilin1 (PSEN1) gene. The missense change affects the PAL (Pro433-Ala434-Leu435) motif critical for catalytic activity of the macromolecular γ-secretase complex. Evolutionary and integrated bioinformatic tools predicted a deleterious effect of the variant supporting its role in the AD pathogenesis.
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Affiliation(s)
- Fausto Roveta
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Andrea Marcinnò
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Alberto Grassini
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Fabio Ferrandes
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Aurora Cermelli
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Silvia Boschi
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
| | - Salvatore Gallone
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Torino, Italy
| | | | | | - Patrizia Dentelli
- Medical Genetics Unit, Cittàdella Salute e della Scienza University Hospital, Torino, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Barbara Pasini
- Medical Genetics Unit, Cittàdella Salute e della Scienza University Hospital, Torino, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Alfredo Brusco
- Medical Genetics Unit, Cittàdella Salute e della Scienza University Hospital, Torino, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Elisa Rubino
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Torino, Italy
| | - Innocenzo Rainero
- Aging Brain and Memory Clinic, Department of Neuroscience, University of Torino, Torino, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza University Hospital, Torino, Italy
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11
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Leone MP, Morlino S, Nardella G, Pracella R, Giachino D, Celli L, Baldo D, Turolla L, Piccione M, Salzano E, Busè M, Lastella P, Zollino M, Cantone R, Grosso E, Zonta A, Pasini B, Piscopo C, De Maggio I, Priolo M, Mammi C, Foiadelli T, Trabatti C, Savasta S, Iolascon A, Ferraris A, Lodato V, Di Giosaffatte N, Majore S, Selicorni A, Petracca A, Fusco C, Celli M, Guarnieri V, Micale L, Castori M. Specifications and validation of the ACMG/AMP criteria for clinical interpretation of sequence variants in collagen genes associated with joint hypermobility. Hum Genet 2023; 142:785-808. [PMID: 37079061 DOI: 10.1007/s00439-023-02547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023]
Abstract
Deleterious variants in collagen genes are the most common cause of hereditary connective tissue disorders (HCTD). Adaptations of the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) criteria are still lacking. A multidisciplinary team was set up for developing specifications of the ACMG/AMP criteria for COL1A1, COL1A2, COL2A1, COL3A1, COL5A1, COL5A2, COL11A1, COL11A2 and COL12A1, associated with various forms of HCTD featuring joint hypermobility, which is becoming one of the most common reasons of referral for molecular testing in this field. Such specifications were validated against 209 variants, and resulted effective for classifying as pathogenic and likely pathogenic null alleles without downgrading of the PVS1 level of strength and recurrent Glycine substitutions. Adaptations of selected criteria reduced uncertainties on private Glycine substitutions, intronic variants predicted to affect the splicing, and null alleles with a downgraded PVS1 level of strength. Segregation and multigene panel sequencing data mitigated uncertainties on non-Glycine substitutions by the attribution of one or more benignity criteria. These specifications may improve the clinical utility of molecular testing in HCTD by reducing the number of variants with neutral/conflicting interpretations. Close interactions between laboratory and clinicians are crucial to estimate the a priori utility of molecular test and to improve medical reports.
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Affiliation(s)
- Maria Pia Leone
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Silvia Morlino
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Grazia Nardella
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Riccardo Pracella
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Daniela Giachino
- Medical Genetics Unit, Department of Clinical and Biological Sciences, University of Turin, AOU 'S. Luigi Gonzaga', Orbassano, Turin, Italy
| | - Luca Celli
- Center for Rare Diseases, AOU Policlinico 'Umberto I', Rome, Italy
| | - Demetrio Baldo
- Medical Genetics Unit, AULSS2 Marca Trevigiana, Treviso, Italy
| | - Licia Turolla
- Medical Genetics Unit, AULSS2 Marca Trevigiana, Treviso, Italy
| | - Maria Piccione
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
- Division of Medical Genetics, AOOR Villa Sofia-Cervello, Palermo, Italy
| | - Emanuela Salzano
- Division of Medical Genetics, AOOR Villa Sofia-Cervello, Palermo, Italy
| | - Martina Busè
- Division of Medical Genetics, AOOR Villa Sofia-Cervello, Palermo, Italy
| | - Patrizia Lastella
- Centro Sovraziendale Malattie Rare - UOC Medicina Interna Universitaria "C. Frugoni" - AOU Policlinico Consorziale di Bari, Bari, Italy
| | - Marcella Zollino
- Institute of Genomic Medicine, Department of Life Sciences and Public Health, 'Sacro Cuore' Catholic University of Rome, Rome, Italy
- Medical Genetics Unit, Foundation IRCCS AOU Policlinico 'A. Gemelli', Rome, Italy
| | - Rachele Cantone
- Medical Genetics Unit, AOU 'Città della Salute e della Scienza' - 'Molinette' Hospital, Turin, Italy
| | - Enrico Grosso
- Medical Genetics Unit, AOU 'Città della Salute e della Scienza' - 'Molinette' Hospital, Turin, Italy
| | - Andrea Zonta
- Medical Genetics Unit, AOU 'Città della Salute e della Scienza' - 'Molinette' Hospital, Turin, Italy
| | - Barbara Pasini
- Medical Genetics Unit, AOU 'Città della Salute e della Scienza' - 'Molinette' Hospital, Turin, Italy
| | - Carmelo Piscopo
- Medical and Laboratory Genetics Unit, AORN 'Antonio Cardarelli', Naples, Italy
| | - Ilaria De Maggio
- Medical and Laboratory Genetics Unit, AORN 'Antonio Cardarelli', Naples, Italy
| | - Manuela Priolo
- Medical Genetics Unit, Grande Ospedale Metropolitano 'Bianchi Melacrino Morelli', Reggio Calabria, Italy
| | - Corrado Mammi
- Medical Genetics Unit, Grande Ospedale Metropolitano 'Bianchi Melacrino Morelli', Reggio Calabria, Italy
| | - Thomas Foiadelli
- Clinica Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chiara Trabatti
- Division of Pediatrics, Azienda Socio Sanitaria Territoriale (ASST) Crema, Crema, Italy
| | - Salvatore Savasta
- Division of Pediatrics, Azienda Socio Sanitaria Territoriale (ASST) Crema, Crema, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, Federico II' University of Naples, Naples, Italy
- CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Alessandro Ferraris
- Clinical Genetics Unit, UOC Laboratory of Medical Genetics, Department of Experimental Medicine at, Sapienza University, AO San Camillo-Forlanini, Rome, Italy
| | - Valentina Lodato
- Clinical Genetics Unit, UOC Laboratory of Medical Genetics, Department of Experimental Medicine at, Sapienza University, AO San Camillo-Forlanini, Rome, Italy
| | - Niccolò Di Giosaffatte
- Clinical Genetics Unit, UOC Laboratory of Medical Genetics, Department of Experimental Medicine at, Sapienza University, AO San Camillo-Forlanini, Rome, Italy
| | - Silvia Majore
- Clinical Genetics Unit, UOC Laboratory of Medical Genetics, Department of Experimental Medicine at, Sapienza University, AO San Camillo-Forlanini, Rome, Italy
| | - Angelo Selicorni
- Department of Pediatrics, Center for Fragile Child, ASST Lariana Sant'Anna Hospital, Como, San Fermo della Battaglia, Italy
| | - Antonio Petracca
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Carmela Fusco
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Mauro Celli
- Center for Rare Diseases, AOU Policlinico 'Umberto I', Rome, Italy
| | - Vito Guarnieri
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Lucia Micale
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy
| | - Marco Castori
- Division of Medical Genetics, Poliambulatorio "Giovanni Paolo II", Fondazione IRCCS-Casa Sollievo della Sofferenza, Viale Padre Pio 7, 71013, San Giovanni Rotondo, Italy.
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12
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Li H, Engel C, Hoya MDL, Peterlongo P, Yannoukakos D, Livraghi L, Radice P, Thomassen M, Hansen TVO, Gerdes AM, Nielsen HR, Caputo SM, Zambelli A, Borg A, Solano A, Thomas A, Parsons MT, Antoniou AC, Leslie G, Yang X, Chenevix-Trench G, Caldes T, Kwong A, Pedersen IS, Lautrup CK, John EM, Terry MB, Hopper JL, Southey MC, Andrulis IL, Tischkowitz M, Janavicius R, Boonen SE, Kroeldrup L, Varesco L, Hamann U, Vega A, Palmero EI, Garber J, Montagna M, Van Asperen CJ, Foretova L, Greene MH, Selkirk T, Moller P, Toland AE, Domchek SM, James PA, Thorne H, Eccles DM, Nielsen SM, Manoukian S, Pasini B, Caligo MA, Lazaro C, Kirk J, Wappenschmidt B, Spurdle AB, Couch FJ, Schmutzler R, Goldgar DE. Risks of breast and ovarian cancer for women harboring pathogenic missense variants in BRCA1 and BRCA2 compared with those harboring protein truncating variants. Genet Med 2022; 24:2208. [PMID: 36205748 DOI: 10.1016/j.gim.2022.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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13
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Bounous VE, Robba E, Perotto S, Pasini B, Tomasi Cont N, Ricci MT, Ditto A, Vitellaro M, Raspagliesi F, Biglia N. Gynecological Cancers in Lynch Syndrome: A Comparison of the Histological Features with Sporadic Cases of the General Population. J Clin Med 2022; 11:jcm11133689. [PMID: 35806973 PMCID: PMC9267402 DOI: 10.3390/jcm11133689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: About 5% of endometrial cancers (ECs) are attributed to an inherited predisposition, for which Lynch syndrome (LS) accounts for the majority of cases. Women with LS have a 40−60% predicted lifetime risk of developing EC, in addition to a 40−80% lifetime risk of developing colorectal cancer and other cancers. In this population, the lifetime risk of developing ovarian cancer (OC) is 10−12%. Object: to compare the histopathological features of LS-associated EC and OC with sporadic cancers in order to evaluate whether there are differences in terms of age at diagnosis, site of occurrence in the uterus, histological type, stage at diagnosis, and tumor grading. Materials and methods: we compared data obtained from 96 patients with LS-associated gynecological cancers (82 with EC and 14 with OC) to a control group (CG) of 209 patients who developed sporadic EC, and a CG of 187 patients with sporadic OC. Results: The mean age at diagnosis of LS-associated EC and OC was much lower than in the control groups. In both groups with EC, the endometrioid histotype was the most frequently occurring histotype. However, among LS women there was a significantly higher incidence of clear cell tumors (11% versus 2.4% in the CG, p = 0.0001). Similar to the sporadic cancer cases, most of the LS-associated ECs presented at an early stage (89% of cases at FIGO I-II stage). In the LS group, the tumor frequently involved only the inner half of the endometrium (77% of cases, p < 0.01). In the LS group, 7.3% of ECs were localized to the lower uterine segment (LUS), whereas no cancer developed in the LUS in the CG. No serous OCs were diagnosed in the LS group (versus 45.5% in the CG, p = 0.0009). Most of the LS-associated OCs presented at an early stage (85% of cases at FIGO I-II stages, p < 0.01). Conclusion: LS-associated EC and OC seem to have peculiar features, occurring at a younger age and at an earlier stage. In LS, EC less frequently involves the outer half of the endometrium, with a more frequent occurrence in the LUS. The presence of clear cell EC was more frequently observed, whereas in OC, the predominant histotype was endometrioid.
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Affiliation(s)
- Valentina Elisabetta Bounous
- Academic Division of Obstetrics and Gynecology—A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (E.R.); (N.B.)
- Correspondence:
| | - Elisabetta Robba
- Academic Division of Obstetrics and Gynecology—A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (E.R.); (N.B.)
| | | | - Barbara Pasini
- Department of Genetics, Biology and Biochemistry, University of Turin, 10128 Turin, Italy;
| | | | - Maria Teresa Ricci
- Unit of Hereditary Digestive Tract Tumors, Fondazione IRCCs—National Cancer Institute, 20133 Milan, Italy; (M.T.R.); (M.V.)
| | - Antonino Ditto
- Division of Gynecologic Oncology, Fondazione IRCCs—National Cancer Institute, 20133 Milan, Italy; (A.D.); (F.R.)
| | - Marco Vitellaro
- Unit of Hereditary Digestive Tract Tumors, Fondazione IRCCs—National Cancer Institute, 20133 Milan, Italy; (M.T.R.); (M.V.)
| | - Francesco Raspagliesi
- Division of Gynecologic Oncology, Fondazione IRCCs—National Cancer Institute, 20133 Milan, Italy; (A.D.); (F.R.)
| | - Nicoletta Biglia
- Academic Division of Obstetrics and Gynecology—A.O. Ordine Mauriziano, University of Turin, 10128 Turin, Italy; (E.R.); (N.B.)
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14
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Berrino E, Filippi R, Visintin C, Peirone S, Fenocchio E, Farinea G, Veglio F, Aglietta M, Sapino A, Cereda M, Visintin R, Pasini B, Marchiò C. Collision of germline POLE and PMS2 variants in a young patient treated with immune checkpoint inhibitors. NPJ Precis Oncol 2022; 6:15. [PMID: 35260767 PMCID: PMC8904527 DOI: 10.1038/s41698-022-00258-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 02/11/2022] [Indexed: 12/30/2022] Open
Abstract
The onset of multiple and metachronous tumors in young patients induces to suspect the presence of genetic variants in genes associated with tumorigenesis. We describe here the unusual case of a 16-year-old patient who developed a synchronous bifocal colorectal adenocarcinoma with distant metastases. We provide high throughput molecular characterization with whole-exome sequencing (WES) and DNA targeted sequencing of different tumoral lesions and normal tissue samples that led to unveil a germline POLE mutation (p.Ser297Cys) coexisting with the PMS2 c.2174 + 1 G > A splicing mutation. This clinical scenario defines a “POLE-LYNCH” collision syndrome, which explains the ultra-mutator phenotype observed in the tumor lesions, and the presence of MMR deficiency-associated unusual signatures. The patient was successfully treated with immune checkpoint inhibitors but subsequently developed a high-grade urothelial carcinoma cured by surgery. We complement this analysis with a transcriptomic characterization of tumoral lesions with a panel targeting 770 genes related to the tumor microenvironment and immune evasion thus getting insight on cancer progression and response to immunotherapy.
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Affiliation(s)
- Enrico Berrino
- Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberto Filippi
- Department of Oncology, University of Turin, Turin, Italy.,Medical Oncology Unit, University Hospital AOU Città della Salute e della Scienza, Turin, Italy
| | - Clara Visintin
- Department of Experimental Oncology, European Institute of Oncology, IEO IRCCS, Milano, Italy
| | - Serena Peirone
- Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy.,Cancer Genomics and Bioinformatics Unit, IIGM-Italian Institute for Genomic Medicine, c/o IRCCS Candiolo, 10060, Turin, Italy
| | | | | | - Franco Veglio
- Department of Medical Sciences, University of Turin, Turin, Italy.,Internal Medicine Unit, University Hospital AOU Città della Salute e della Scienza, Turin, Italy
| | - Massimo Aglietta
- Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Anna Sapino
- Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Matteo Cereda
- Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy.,Cancer Genomics and Bioinformatics Unit, IIGM-Italian Institute for Genomic Medicine, c/o IRCCS Candiolo, 10060, Turin, Italy
| | - Rosella Visintin
- Department of Experimental Oncology, European Institute of Oncology, IEO IRCCS, Milano, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy. .,Medical Genetics Unit, University Hospital AOU Città della Salute e della Scienza, Turin, Italy.
| | - Caterina Marchiò
- Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy. .,Department of Medical Sciences, University of Turin, Turin, Italy.
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15
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Parasiliti-Caprino M, Bioletto F, Lopez C, Maletta F, Caputo M, Gasco V, La Grotta A, Limone P, Borretta G, Volante M, Papotti M, Terzolo M, Morino M, Pasini B, Veglio F, Ghigo E, Arvat E, Maccario M. Development and internal validation of a predictive model for the estimation of pheochromocytoma recurrence risk after radical surgery. Eur J Endocrinol 2022; 186:399-406. [PMID: 35363157 DOI: 10.1530/eje-21-0370] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 01/17/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Various features have been identified as predictors of relapse after complete resection of pheochromocytoma, but a comprehensive multivariable model for recurrence risk prediction is lacking. The aim of this study was to develop and internally validate an integrated predictive model for post-surgical recurrence of pheochromocytoma. METHODS The present research retrospectively enrolled 177 patients affected by pheochromocytoma and submitted to radical surgery from 1990 to 2016, in nine referral centers for adrenal diseases. Cox regression analysis was adopted for model development, and a bootstrapping procedure was used for internal validation. RESULTS Variables independently associated with recurrence were tumor size (hazard ratio (HR): 1.01, 95% CI: 1.00-1.02), positive genetic testing (HR: 5.14, 95% CI: 2.10-12.55), age (HR: 0.97, 95% CI: 0.94-0.99), and Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) (HR: 1.16, 95% CI: 1.04-1.29). The predictive performance of the overall model, evaluated by Somers' D, was equal to 0.594, and was significantly higher than the ones of any single predictor alone (P = 0.002 compared to tumor size; P = 0.004 compared to genetic testing; P = 0.048 compared to age; P = 0.006 compared to PASS). Internal validation by bootstrapping techniques estimated an optimistic bias of 6.3%, which reassured about a small tendency towards overfit. CONCLUSIONS We proposed a multivariable model for the prediction of post-surgical recurrence of pheochromocytoma, derived by the integration of genetic, histopathological, and clinical data. This predictive tool may be of value for a comprehensive tailoring of post-surgical follow-up in radically operated pheochromocytoma patients.
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Affiliation(s)
| | - Fabio Bioletto
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences
| | - Chiara Lopez
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences
| | - Francesca Maletta
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Marina Caputo
- Endocrinology and Diabetes, University of Eastern Piedmont, Novara, Italy
| | - Valentina Gasco
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences
| | - Antonio La Grotta
- Endocrinology and Hypertension, Cardinal Massaia Hospital, Asti, Italy
| | - Paolo Limone
- Endocrinology, Diabetes and Metabolism, A.O. Ordine Mauriziano, Turin, Italy
| | - Giorgio Borretta
- Endocrinology and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy
| | - Marco Volante
- Pathology Unit, Department of Oncology, University of Turin, Orbassano, Italy
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Massimo Terzolo
- Internal Medicine, Department of Biological and Clinical Sciences, University of Turin, Orbassano, Italy
| | | | | | - Franco Veglio
- Internal Medicine and Hypertension Unit, Department of Medical Sciences
| | - Ezio Ghigo
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences
| | - Emanuela Arvat
- Oncological Endocrinology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro Maccario
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences
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16
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Li H, Engel C, de la Hoya M, Peterlongo P, Yannoukakos D, Livraghi L, Radice P, Thomassen M, Hansen TVO, Gerdes AM, Nielsen HR, Caputo SM, Zambelli A, Borg A, Solano A, Thomas A, Parsons MT, Antoniou AC, Leslie G, Yang X, Chenevix-Trench G, Caldes T, Kwong A, Pedersen IS, Lautrup CK, John EM, Terry MB, Hopper JL, Southey MC, Andrulis IL, Tischkowitz M, Janavicius R, Boonen SE, Kroeldrup L, Varesco L, Hamann U, Vega A, Palmero EI, Garber J, Montagna M, Van Asperen CJ, Foretova L, Greene MH, Selkirk T, Moller P, Toland AE, Domchek SM, James PA, Thorne H, Eccles DM, Nielsen SM, Manoukian S, Pasini B, Caligo MA, Lazaro C, Kirk J, Wappenschmidt B, Spurdle AB, Couch FJ, Schmutzler R, Goldgar DE. Risks of breast and ovarian cancer for women harboring pathogenic missense variants in BRCA1 and BRCA2 compared with those harboring protein truncating variants. Genet Med 2022; 24:119-129. [PMID: 34906479 PMCID: PMC10170303 DOI: 10.1016/j.gim.2021.08.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/22/2021] [Accepted: 08/25/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Germline genetic testing for BRCA1 and BRCA2 variants has been a part of clinical practice for >2 decades. However, no studies have compared the cancer risks associated with missense pathogenic variants (PVs) with those associated with protein truncating (PTC) variants. METHODS We collected 582 informative pedigrees segregating 1 of 28 missense PVs in BRCA1 and 153 pedigrees segregating 1 of 12 missense PVs in BRCA2. We analyzed 324 pedigrees with PTC variants in BRCA1 and 214 pedigrees with PTC variants in BRCA2. Cancer risks were estimated using modified segregation analysis. RESULTS Estimated breast cancer risks were markedly lower for women aged >50 years carrying BRCA1 missense PVs than for the women carrying BRCA1 PTC variants (hazard ratio [HR] = 3.9 [2.4-6.2] for PVs vs 12.8 [5.7-28.7] for PTC variants; P = .01), particularly for missense PVs in the BRCA1 C-terminal domain (HR = 2.8 [1.4-5.6]; P = .005). In case of BRCA2, for women aged >50 years, the HR was 3.9 (2.0-7.2) for those heterozygous for missense PVs compared with 7.0 (3.3-14.7) for those harboring PTC variants. BRCA1 p.[Cys64Arg] and BRCA2 p.[Trp2626Cys] were associated with particularly low risks of breast cancer compared with other PVs. CONCLUSION These results have important implications for the counseling of at-risk women who harbor missense PVs in the BRCA1/2 genes.
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Affiliation(s)
- Hongyan Li
- Cancer Control and Population Science, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Miguel de la Hoya
- Molecular Oncology Laboratory, CIBERONC, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, National Centre for Scientific Research "Demokritos", INRASTES Institute of Nuclear & Radiological Sciences & Technology, Energy & Safety, Athens, Greece
| | - Luca Livraghi
- Medical Oncology Unit, AZIENDA SOCIO SANITARIA TERRITORIALE PAPA GIOVANNI XXIII, Bergamo, Italy; University of Siena, Siena, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Thomas V O Hansen
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henriette R Nielsen
- Department of Clinical Genetics Sygehus Lillebaelt, Vejle Hospital, Vejle, Denmark
| | - Sandrine M Caputo
- Service de Génétique, Institut Curie, Paris, France; Paris Sciences and Lettres Research University, Paris, France
| | - Alberto Zambelli
- Medical Oncology Unit, AZIENDA SOCIO SANITARIA TERRITORIALE PAPA GIOVANNI XXIII, Bergamo, Italy
| | - Ake Borg
- Divisions of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Angela Solano
- INBIOMED, Faculty of Medicine, University of Buenos Aires, CONICET and Genotyping Laboratory, Department of Clinical Chemistry, CEMIC, Buenos Aires, Argentina
| | - Abigail Thomas
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Xin Yang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Trinidad Caldes
- Molecular Oncology Laboratory, CIBERONC, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Ava Kwong
- Cancer Genetics Centre, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong; Department of Surgery, LKS Faculty of Medicine,University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Inge Søkilde Pedersen
- Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark; Clinical Cancer Research Center and Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, The Faculty of Medicine, Aalborg University of Aalborg, Aalborg, Denmark
| | - Charlotte K Lautrup
- Clinical Cancer Research Center and Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, The Faculty of Medicine, Aalborg University of Aalborg, Aalborg, Denmark
| | - Esther M John
- Department of Epidemiology & Population Health and Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Department of Clinical Pathology, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Marc Tischkowitz
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom
| | - Ramunas Janavicius
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Susanne E Boonen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Lone Kroeldrup
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Liliana Varesco
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ana Vega
- Fundación Pública galega Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | - Edenir I Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo, Brazil; National Cancer Institute, Rio de Janeiro, Brazil
| | - Judy Garber
- Center for Cancer Genetics and Prevention, Dana-Farber Cancer Institute, Boston, MA
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, IOV - Istituto Oncologico Veneto - IRCCS, Padova, Italy
| | - Christi J Van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Mark H Greene
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Tina Selkirk
- NorthShore University HealthSystem, University of Chicago, Evanston, IL
| | - Pal Moller
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway; Center for Hereditary Tumors, HELIOS-Klinikum Wuppertal, University of Witten-Herdecke, Wuppertal, Germany
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University, Columbus, OH
| | - Susan M Domchek
- Basser Center for BRCA, Abramson Cancer Center, Penn Medicine, University of Pennsylvania, Philadelphia, PA
| | - Paul A James
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; The Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Heather Thorne
- The Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sarah M Nielsen
- Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Barbara Pasini
- Medical Genetics Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Maria A Caligo
- SOD Genetica Molecolare, University Hospital, Pisa, Italy
| | - Conxi Lazaro
- ONCOBELL-IDIBELL-IDIBGI-IGTP, CIBERONC, Hereditary Cancer Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Judy Kirk
- Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney Medical School, University of Sydney, Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Barbara Wappenschmidt
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Integrated Oncology (CIO), Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Amanda B Spurdle
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Rita Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Center for Integrated Oncology (CIO), Faculty of Medicine, University of Cologne, Cologne, Germany
| | - David E Goldgar
- Cancer Control and Population Science, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT.
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Pavanello E, Sciarrone A, Guaraldo V, Muccinelli E, Ciuffreda VP, Sauro P, Bondielli G, Mirante S, Mengozzi G, Viora E, Cuckle H, Pasini B. Cell-free DNA screening for fetal aneuploidy using the rolling circle method: A step towards non invasive prenatal testing simplification. Prenat Diagn 2021; 41:1694-1700. [PMID: 34569636 DOI: 10.1002/pd.6050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/24/2021] [Accepted: 09/09/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess the efficacy of cell-free (cf)DNA screening for aneuploidy using the automated system based on rolling circle replication. METHODS A prospective study among women referred for invasive prenatal diagnosis between July 2018 and December 2019. The plasma fraction was extracted within 5 days from blood collection, stored at -20°C and cfDNA measured between January and December 2019. RESULTS A total of 805 women were recruited; 778 with singleton pregnancies and 27 twins. There were 48 Down syndrome, 25 Edwards syndrome and 3 Patau syndrome cases. Overall, the no-call rate was 2.6% (95% confidence interval 1.6%-3.9%) which reduced from 4.7% to 1.1% after relocation of the system (p < 0.002) to ensure a constant ambient temperature below 25°C. In singletons the Down syndrome detection rate (DR) was 100% (93%-100%) and false-positive rate (FPR) 0.14% (0.00%-0.79%). The Edwards syndrome DR was 96% (80%-100%) and FPR 0.78% (0.29%-1.7%). One false-positive had a confined placental trisomy 18 and the remaining five a z-score requiring sample repetition; all the false-positives occurred before system relocation (p < 0.005). Patau syndrome DR and FPR were 67% (9.4%-99%) and 0.26% (0.03%-0.95%). CONCLUSION The cfDNA rolling circle method yields similar results to other methods provided that room temperature is adequately controlled.
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Affiliation(s)
- Enza Pavanello
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Andrea Sciarrone
- Department of Obstetrics and Gynecology (St Anna Hospital), Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Varvara Guaraldo
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Elisabetta Muccinelli
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Valentina Pia Ciuffreda
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Pina Sauro
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Giulia Bondielli
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Sandra Mirante
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Giulio Mengozzi
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Elsa Viora
- Department of Obstetrics and Gynecology (St Anna Hospital), Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Howard Cuckle
- Department of Reproductive Epidemiology, Faculty of Medicine, Tel Aviv University, Tel Aviv Aviv, Israel
| | - Barbara Pasini
- Department of Laboratory Medicine, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
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18
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Giannone G, Scotto G, Katsaros D, De Giorgi U, Farolfi A, Borella F, Cosma S, Ferrero A, Mangiacotti S, Villa M, Tuninetti V, Ghisoni E, Turinetto M, Mittica G, Gemmiti S, Zavallone L, Aglietta M, Pasini B, Di Maio M, Valabrega G. Hypersensitivity to platinum salts according to BRCA status in ovarian cancer: A retrospective analysis of clinical outcomes and systematic review of literature. Gynecol Oncol 2021; 162:80-87. [PMID: 33896588 DOI: 10.1016/j.ygyno.2021.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hypersensitivity reactions (HSRs) to platinum are an important issue in the treatment of patients (pts) with ovarian cancer (OC). Germline BRCA mutations have been proposed as a risk factor. We aimed at evaluating the incidence and severity of HSRs to platinum in OC pts. with known BRCA status. PATIENTS AND METHODS We retrospectively analyzed 432 pts. from 5 Italian Centers. In addition, we performed a systematic review and meta-analysis of published series. RESULTS Four hundred nine pts. received at least one prior platinum-based treatment line: 314 were BRCA wild type (77%) and 95 were BRCA mutated (23%). There was no statistical difference in exposure to platinum. Incidence of any grade HSRs was higher among BRCA mutated pts. [9% vs 18%, p = 0.019] and the time-to-HSRs curves show that the risk increases with the duration of platinum exposure, in BRCA mutated pts. more than in BRCA wild type. A multivariable analysis showed that harboring a germline BRCA mutation was related to a higher incidence of HSRs (HR: 1.84, 95% CI 1.00-3.99, p = 0.05) while having received pegylated liposomal doxorubicin (PLD) was related to a lower incidence of HSRs (HR: 0.03 95% CI 0.004-0.22, p = 0.001). The systematic review confirmed the higher incidence of HSRs in BRCA mutated pts., though heterogeneity among series was significant. CONCLUSIONS In OC pts. with BRCA mutations, there is a significantly higher incidence of HSRs to carboplatin, not justified by longer drug exposure. On the other hand, PLD exerted a protective role in our series.
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Affiliation(s)
- G Giannone
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy.
| | - G Scotto
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - D Katsaros
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - U De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - A Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - F Borella
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - S Cosma
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - A Ferrero
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
| | | | - M Villa
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
| | - V Tuninetti
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - E Ghisoni
- Department of Oncology, Lausanne University Hospital, Switzerland; Ludwig Institute for Cancer Research, Lausanne, Switzerland
| | - M Turinetto
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - G Mittica
- Unit of Oncology, ASL Verbano Cusio Ossola (VCO), Omegna (VB), Italy
| | - S Gemmiti
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - L Zavallone
- Department of Medical Oncology, Infermi Hospital, Biella, Italy
| | - M Aglietta
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - B Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Di Maio
- Department of Oncology, A.O. Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - G Valabrega
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
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19
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Giannone G, Scotto G, De Giorgi U, Farolfi A, Katsaros D, Borella F, Ferrero A, Villa M, Tuninetti V, Ghisoni E, Turinetto M, Zavallone L, Aglietta M, Pasini B, Di Maio M, Valabrega G. Hypersensitivity to platinum salts according to BRCA status in ovarian cancer: Retrospective analysis of clinical outcomes. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6053 Background: Hypersensitivity reactions (HSRs) to platinum salts are an important issue in the treatment of ovarian cancer (OC) patients (pts). Few data suggest that, along with number of previous cycles, germline BRCA mutations could be a risk factor. We aimed at evaluating the incidence and severity of HSRs to platinum salts in a large group of OC pts with known BRCA status and correlated them with drug exposure time. Methods: Between March 2003 and September 2019, 432 pts with a diagnosis of OC and a known BRCA status, were recorded in our 5 Institutions and retrospectively analyzed. The following data were collected: histology, BRCA status, type of surgery and first line therapy, number of total lines and cycles received, line and cycle of HSR onset, symptoms, history of other allergies and if desensitization was attempted. We graded the severity of HSRs according to CTCAE v5.0. We calculated the total duration of exposure to platinum salts, summing up the duration of all platinum lines received by the pts. Results: Four hundred nine of 432 (94.7%) pts were treated with at least one platinum-based line of therapy and were eligible for the analysis. Among them, 314 pts were BRCA wild type (BRCAwt) (76.8%) and 95 were BRCA mutated (BRCAmut) (23.2%). There was no statistical difference in number of prior lines of therapy [median 1 (2-6) for BRCA wt and 2 (1-6) for BRCAmut pts (p = 0.194)] and duration of exposure to platinum [median 126 (42 – 893) and 197 (42 – 896) days for BRCAwt and BRCAmut pts, respectively (p = 0.145)]. Incidence of any grade HSRs was 29 / 314 (9.2%) among BRCAwt pts vs. 17/ 95 (17.9%) among BRCAmut pts (Odds ratio [OR] 0.47, 95% CI 0.24 – 0.89, p= 0.019). All recorded HSRs to platinum salts were related to carboplatin. We observed a numerically higher incidence of Grade 3-4 HSRs in BRCAmut pts (5.1% in BRCAwt vs. 10.5% in BRCAmut cohort, OR 0.46, 95% CI 0.20 – 1.04, p = 0.057). The risk to develop HSRs increases with duration of exposure to platinum, particularly in BRCAmut pts. The cumulative incidence of any grade HSRs was 20.6% vs. 23.3% after 12 months and 38.4% vs. 59.7% after 18 months in BRCAwt and BRCAmut pts, respectively (Hazard Ratio [HR] 1.72, 95% CI 0.94 – 3.12, p = 0.073). The cumulative incidence of severe HSRs was 10.9% vs. 15.7% after 12 months and 26.5% vs. 41.0% after 18 months in BRCAwt and BRCAmut pts, respectively (HR 1.88, 95% CI 0.85 – 4.16, p = 0.11). Conclusions: In BRCAmut OC pts, there is a significantly higher incidence of HSRs to carboplatin, that seems not justified by longer drug exposure only.
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Affiliation(s)
- Gaia Giannone
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Giulia Scotto
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Department of Medical Oncology,Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Dionyssios Katsaros
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, Torino, Italy
| | - Fulvio Borella
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, Torino, Italy
| | - Annamaria Ferrero
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Torin, Italy
| | - Michela Villa
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Torin, Italy
| | | | | | | | - Laura Zavallone
- Department Medical Oncology, Infermi Hospital, Biella, Italy
| | | | - Barbara Pasini
- Department of Medical Science, University of Turin, Torino, Italy
| | - Massimo Di Maio
- Department of Oncology, A.O. Ordine Mauriziano Hospital, University of Turin, Turin, Italy
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20
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Burrello J, Monticone S, Losano I, Cavaglià G, Buffolo F, Tetti M, Covella M, Rabbia F, Veglio F, Pasini B, Williams TA, Mulatero P. Prevalence of Hypokalemia and Primary Aldosteronism in 5100 Patients Referred to a Tertiary Hypertension Unit. Hypertension 2020; 75:1025-1033. [PMID: 32114853 DOI: 10.1161/hypertensionaha.119.14063] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Primary aldosteronism (PA) was considered a rare disorder almost always associated with hypokalemia. The widespread screening of patients with hypertension unveiled an increased prevalence of PA with normokalemic hypertension the prevailing phenotype. Many studies have reported the prevalence of hypokalemia in patients with PA; conversely, the prevalence of PA in patients with hypokalemia is unknown. In this retrospective observational study, we define the prevalence of hypokalemia in referred patients with hypertension and the prevalence of PA in patients with hypokalemia and hypertension. Hypokalemia was present in 15.8% of 5100 patients with hypertension, whereas 76.9% were normokalemic, and 7.3% hyperkalemic. The prevalence of PA in patients with hypokalemia was 28.1% and increased with decreasing potassium concentrations up to 88.5% of patients with spontaneous hypokalemia and potassium concentrations <2.5 mmol/L. A multivariate regression analysis demonstrated the association of hypokalemia with the occurrence of cardiovascular events independent of PA diagnosis. An association of PA with the occurrence of cardiovascular events and target organ damage independent of hypokalemia was also demonstrated. In conclusion, our results confirm that PA is a frequent cause of secondary hypertension in patients with hypokalemia, and the presence of hypertension and spontaneous hypokalemia are strong indications for PA diagnosis. Finally, we show that PA and hypokalemia are associated with an increased risk of cardiovascular events.
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Affiliation(s)
- Jacopo Burrello
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Silvia Monticone
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Isabel Losano
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Giovanni Cavaglià
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Fabrizio Buffolo
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Martina Tetti
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Michele Covella
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Franco Rabbia
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Franco Veglio
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
| | - Barbara Pasini
- Medical Genetics Unit (B.P.), Department of Medical Sciences, University of Turin, Italy
| | - Tracy Ann Williams
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy.,Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Germany (T.A.W.)
| | - Paolo Mulatero
- From the Division of Internal Medicine and Hypertension (J.B., S.M., I.L., G.C., F.B., M.T., M.C., F.R., F.V., T.A.W., P.M.), Department of Medical Sciences, University of Turin, Italy
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21
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Laitman Y, Friebel TM, Yannoukakos D, Fostira F, Konstantopoulou I, Figlioli G, Bonanni B, Manoukian S, Zuradelli M, Tondini C, Pasini B, Peterlongo P, Plaseska-Karanfilska D, Jakimovska M, Majidzadeh K, Zarinfam S, Loizidou MA, Hadjisavvas A, Michailidou K, Kyriacou K, Behar DM, Molho RB, Ganz P, James P, Parsons MT, Sallam A, Olopade OI, Seth A, Chenevix-Trench G, Leslie G, McGuffog L, Marafie MJ, Megarbane A, Al-Mulla F, Rebbeck TR, Friedman E. The spectrum of BRCA1 and BRCA2 pathogenic sequence variants in Middle Eastern, North African, and South European countries. Hum Mutat 2019; 40:e1-e23. [PMID: 31209999 DOI: 10.1002/humu.23842] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/25/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022]
Abstract
BRCA1 BRCA2 mutational spectrum in the Middle East, North Africa, and Southern Europe is not well characterized. The unique history and cultural practices characterizing these regions, often involving consanguinity and inbreeding, plausibly led to the accumulation of population-specific founder pathogenic sequence variants (PSVs). To determine recurring BRCA PSVs in these locales, a search in PUBMED, EMBASE, BIC, and CIMBA was carried out combined with outreach to researchers from the relevant countries for unpublished data. We identified 232 PSVs in BRCA1 and 239 in BRCA2 in 25 of 33 countries surveyed. Common PSVs that were detected in four or more countries were c.5266dup (p.Gln1756Profs), c.181T>G (p.Cys61Gly), c.68_69del (p.Glu23Valfs), c.5030_5033del (p.Thr1677Ilefs), c.4327C>T (p.Arg1443Ter), c.5251C>T (p.Arg1751Ter), c.1016dup (p.Val340Glyfs), c.3700_3704del (p.Val1234Glnfs), c.4065_4068del (p.Asn1355Lysfs), c.1504_1508del (p.Leu502Alafs), c.843_846del (p.Ser282Tyrfs), c.798_799del (p.Ser267Lysfs), and c.3607C>T (p.Arg1203Ter) in BRCA1 and c.2808_2811del (p.Ala938Profs), c.5722_5723del (p.Leu1908Argfs), c.9097dup (p.Thr3033Asnfs), c.1310_1313del (p. p.Lys437Ilefs), and c.5946del (p.Ser1982Argfs) for BRCA2. Notably, some mutations (e.g., p.Asn257Lysfs (c.771_775del)) were observed in unrelated populations. Thus, seemingly genotyping recurring BRCA PSVs in specific populations may provide first pass BRCA genotyping platform.
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Affiliation(s)
- Yael Laitman
- The Susanne Levy Gertner Oncogenetics Unit, The Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Gisella Figlioli
- Genome Diagnostics Program, IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Monica Zuradelli
- Medical Oncology and Hematology Department, Humanitas Cancer Center, Milan, Italy
| | - Carlo Tondini
- Department of Medical Oncology, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Dijana Plaseska-Karanfilska
- Macedonian Academy of Sciences and Arts Research Centre for Genetic Engineering and Biotechnology, Skopje, Republic of Macedonia
| | - Milena Jakimovska
- Macedonian Academy of Sciences and Arts Research Centre for Genetic Engineering and Biotechnology, Skopje, Republic of Macedonia
| | - Keivan Majidzadeh
- Department of Genetics, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Shiva Zarinfam
- Department of Genetics, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Maria A Loizidou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Andreas Hadjisavvas
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Kyriaki Michailidou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Kyriacos Kyriacou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | | | - Rinat Bernstein Molho
- The Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Patricia Ganz
- Schools of Medicine and Public Health, Division of Cancer Prevention & Control Research, Jonsson Comprehensive Cancer Centre, UCLA, Los Angeles, CA
| | - Paul James
- Parkville Familial Cancer Peter MacCallum Cancer Center, Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland Institute of Medical Research, Brisbane, Australia
| | - Aminah Sallam
- Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL
| | | | - Arun Seth
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Canada
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland Institute of Medical Research, Brisbane, Australia
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | | | | | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Timothy R Rebbeck
- Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, The Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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22
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Giorgio E, Garelli E, Carando A, Bellora S, Rubino E, Quarello P, Sirchia F, Marrama F, Gallone S, Grosso E, Pasini B, Massa R, Brussino A, Brusco A. Design of a multiplex ligation-dependent probe amplification assay for SLC20A2: identification of two novel deletions in primary familial brain calcification. J Hum Genet 2019; 64:1083-1090. [PMID: 31501477 DOI: 10.1038/s10038-019-0668-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 01/13/2023]
Abstract
Primary familial brain calcification (PFBC) is a rare disease characterized by brain calcifications that mainly affect the basal ganglia, thalamus, and cerebellum. Among the four autosomal-dominant genes known to be associated with the disease, SLC20A2 pathogenic variants are the most common, accounting for up to 40% of PFBC dominant cases; variants include both point mutations, small insertions/deletions and intragenic deletions. Over the last 7 years, we have collected a group of 50 clinically diagnosed PFBC patients, who were screened for single nucleotide changes and small insertions/deletions in SLC20A2 by Sanger sequencing. We found seven pathogenic/likely pathogenic variants: four were previously described by our group, and three are reported here (c.303delG, c.21delG, and c.1795-1G>A). We developed and validated a synthetic Multiplex Ligation-dependent Probe Amplification (MLPA) assay for SLC20A2 deletions, covering all ten coding exons and the 5' UTR (SLC20A2-MLPA). Using this method, we screened a group of 43 PFBC-patients negative for point mutations and small insertions/deletions, and identified two novel intragenic deletions encompassing exon 6 NC_000008.10:g.(42297172_42302163)_(423022281_42317413)del, and exons 7-11 including the 3'UTR NC_000008.10:g.(?_42275320)_(42297172_42302163)del. Overall, SLC20A2 deletions may be highly underestimated PFBC cases, and we suggest MLPA should be included in the routine molecular test for PFBC diagnosis.
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Affiliation(s)
- Elisa Giorgio
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - Emanuela Garelli
- Department of Public Health and Pediatric Sciences, University of Torino, Turin, Italy
| | - Adriana Carando
- Department of Public Health and Pediatric Sciences, University of Torino, Turin, Italy
| | - Stefania Bellora
- Pediatric Neuropsychiatry Unit, "SS Antonio e Biagio e Cesare Arrigo" Hospital, Alessandria, Italy
| | - Elisa Rubino
- Department of Neuroscience and Mental Health, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Paola Quarello
- Department of Public Health and Pediatric Sciences, University of Torino, Turin, Italy
| | - Fabio Sirchia
- Institute for Maternal and Child Health IRCCS Burlo Garofalo, Trieste, Italy
| | - Federico Marrama
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Salvatore Gallone
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Turin, Italy
| | - Enrico Grosso
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Torino, Turin, Italy.,Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - Roberto Massa
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Alfredo Brusco
- Department of Medical Sciences, University of Torino, Turin, Italy. .,Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy.
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23
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Gori S, Barberis M, Bella MA, Buttitta F, Capoluongo E, Carrera P, Colombo N, Cortesi L, Genuardi M, Gion M, Guarneri V, Incorvaia L, La Verde N, Lorusso D, Marchetti A, Marchetti P, Normanno N, Pasini B, Pensabene M, Pignata S, Radice P, Ricevuto E, Sapino A, Tagliaferri P, Tassone P, Trevisiol C, Truini M, Varesco L, Russo A. Recommendations for the implementation of BRCA testing in ovarian cancer patients and their relatives. Crit Rev Oncol Hematol 2019; 140:67-72. [DOI: 10.1016/j.critrevonc.2019.05.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/01/2023] Open
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24
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Gambale A, Russo R, Andolfo I, Quaglietta L, De Rosa G, Contestabile V, De Martino L, Genesio R, Pignataro P, Giglio S, Capasso M, Parasole R, Pasini B, Iolascon A. Germline mutations and new copy number variants among 40 pediatric cancer patients suspected for genetic predisposition. Clin Genet 2019; 96:359-365. [DOI: 10.1111/cge.13600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Antonella Gambale
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Lucia Quaglietta
- Azienda Ospedaliera di Rilievo Nazionale Santobono PausiliponS.C. Pediatria Oncologia, Dip. di Oncoematologia Pediatrica Napoli Italy
| | - Gianluca De Rosa
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Valentina Contestabile
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Lucia De Martino
- Azienda Ospedaliera di Rilievo Nazionale Santobono PausiliponS.C. Pediatria Oncologia, Dip. di Oncoematologia Pediatrica Napoli Italy
| | - Rita Genesio
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
| | - Piero Pignataro
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
| | - Sabrina Giglio
- Biomedical Experimental and Clinical Sciences "Mario Serio"University of Florence Florence Italy
- SOD Genetica MedicaAzienda Ospedaliero‐Universitaria Meyer Florence Italy
| | - Mario Capasso
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
- IRCCS SDN Naples Italy
| | - Rosanna Parasole
- Azienda Ospedaliera di Rilievo Nazionale Santobono PausiliponS.C. Pediatria Oncologia, Dip. di Oncoematologia Pediatrica Napoli Italy
| | - Barbara Pasini
- Dipartimento di Scienze MedicheUniversità degli Studi di Torino Torino Italy
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
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25
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Gironi LC, Colombo E, Brusco A, Grosso E, Naretto VG, Guala A, Di Gregorio E, Zonta A, Zottarelli F, Pasini B, Savoia P. Congenital Sensorineural Hearing Loss and Inborn Pigmentary Disorders: First Report of Multilocus Syndrome in Piebaldism. ACTA ACUST UNITED AC 2019; 55:medicina55070345. [PMID: 31284637 PMCID: PMC6681376 DOI: 10.3390/medicina55070345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 12/19/2022]
Abstract
Congenital sensorineural hearing loss may occur in association with inborn pigmentary defects of the iris, hair, and skin. These conditions, named auditory-pigmentary disorders (APDs), represent extremely heterogeneous hereditary diseases, including Waardenburg syndromes, oculocutaneous albinism, Tietz syndrome, and piebaldism. APDs are part of the neurocristopathies, a group of congenital multisystem disorders caused by an altered development of the neural crest cells, multipotent progenitors of a wide variety of different lineages, including those differentiating into peripheral nervous system glial cells and melanocytes. We report on clinical and genetic findings of two monozygotic twins from a large Albanian family who showed a complex phenotype featured by sensorineural congenital deafness, severe neuropsychiatric impairment, and inborn pigmentary defects of hair and skin. The genetic analyzes identified, in both probands, an unreported co-occurrence of a new heterozygous germline pathogenic variant (c.2484 + 5G > T splicing mutation) in the KIT gene, consistent with the diagnosis of piebaldism, and a heterozygous deletion at chromosome 15q13.3, responsible for the neuropsychiatric impairment. This case represents the first worldwide report of dual locus inherited syndrome in piebald patients affected by a complex auditory-pigmentary multisystem phenotype. Here we also synthesize the clinical and genetic findings of all known neurocristopathies characterized by a hypopigmentary congenital disorder.
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Affiliation(s)
- Laura Cristina Gironi
- Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, 28100 Novara, Italy.
| | - Enrico Colombo
- Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, 28100 Novara, Italy
| | - Alfredo Brusco
- Department of Medical Sciences, University of Turin, 10124 Torino, Italy
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10124 Torino, Italy
| | - Enrico Grosso
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10124 Torino, Italy
| | - Valeria Giorgia Naretto
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10124 Torino, Italy
| | - Andrea Guala
- Maternal Infant Department, Castelli Hospital, 28922 Verbania, Italy
| | - Eleonora Di Gregorio
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10124 Torino, Italy
| | - Andrea Zonta
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10124 Torino, Italy
| | - Francesca Zottarelli
- Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, 28100 Novara, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, 10124 Torino, Italy
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, 10124 Torino, Italy
| | - Paola Savoia
- Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, 28100 Novara, Italy
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26
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Mancini C, Zonta A, Botta G, Breda Klobus A, Valbonesi S, Pasini B, Giorgio E, Viora E, Brusco A, Brussino A. A fetal case of microphthalmia and limb anomalies with abnormal neuronal migration associated with SMOC1 biallelic variants. Eur J Med Genet 2018; 62:103578. [PMID: 30445150 DOI: 10.1016/j.ejmg.2018.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/26/2018] [Accepted: 11/09/2018] [Indexed: 01/30/2023]
Abstract
Microphthalmia with limb anomalies (MLA, OMIM, 206920) is a rare autosomal-recessive disease caused by biallelic pathogenic variants in the SMOC1 gene. It is characterized by ocular disorders (microphtalmia or anophtalmia) and limb anomalies (oligodactyly, syndactyly, and synostosis of the 4th and 5th metacarpals), variably associated with long bone hypoplasia, horseshoe kidney, venous anomalies, vertebral anomalies, developmental delay, and intellectual disability. Here, we report the case of a woman who interrupted her pregnancy after ultrasound scans revealed a depression of the frontal bone, posterior fossa anomalies, cerebral ventricular enlargement, cleft spine involving the sacral and lower-lumbar vertebrae, and bilateral microphthalmia. Micrognathia, four fingers in both feet and a slight tibial bowing were added to the clinical picture after fetal autopsy. Exome sequencing identified two variants in the SMOC1 gene, each inherited from one of the parents: c.709G>T - p.(Glu237*) on exon 8 and c.1223G>A - p.(Cys408Tyr) on exon 11, both predicted to be pathogenic by different bioinformatics software. Brain histopathology showed an abnormal cortical neuronal migration, which could be related to the SMOC1 protein function, given its role in cellular signaling, proliferation and migration. Finally, we summarize phenotypic and genetic data of known MLA cases showing that our case has some unique features (Chiari II malformation; focal neuropathological alterations) that could be part of the variable phenotype of SMOC1-associated diseases.
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Affiliation(s)
- Cecilia Mancini
- University of Torino, Department of Medical Sciences, 10126, Torino, Italy
| | - Andrea Zonta
- Città Della Salute e Della Scienza University Hospital, Medical Genetics Unit, 10126, Torino, Italy
| | - Giovanni Botta
- Città Della Salute e Della Scienza University Hospital, Departments of Pathology, 10126, Torino, Italy
| | | | | | - Barbara Pasini
- Città Della Salute e Della Scienza University Hospital, Medical Genetics Unit, 10126, Torino, Italy
| | - Elisa Giorgio
- University of Torino, Department of Medical Sciences, 10126, Torino, Italy
| | - Elsa Viora
- Città Della Salute e Della Scienza University Hospital, Department of Gynecology and Obstetrics, Ultrasound and Prenatal Diagnosis Unit, 10126, Torino, Italy
| | - Alfredo Brusco
- University of Torino, Department of Medical Sciences, 10126, Torino, Italy; Città Della Salute e Della Scienza University Hospital, Medical Genetics Unit, 10126, Torino, Italy.
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27
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Betti M, Aspesi A, Ferrante D, Sculco M, Righi L, Mirabelli D, Napoli F, Rondón-Lagos M, Casalone E, Vignolo Lutati F, Ogliara P, Bironzo P, Gironi CL, Savoia P, Maffè A, Ungari S, Grosso F, Libener R, Boldorini R, Valiante M, Pasini B, Matullo G, Scagliotti G, Magnani C, Dianzani I. Sensitivity to asbestos is increased in patients with mesothelioma and pathogenic germline variants in BAP1
or other DNA repair genes. Genes Chromosomes Cancer 2018; 57:573-583. [DOI: 10.1002/gcc.22670] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/25/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Marta Betti
- Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Anna Aspesi
- Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte; University of Piemonte Orientale; Novara Italy
| | - Marika Sculco
- Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Luisella Righi
- Department of Oncology; University of Turin at San Luigi Hospital; Turin Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology; CPO-Piemonte and University of Turin; Turin Italy
| | - Francesca Napoli
- Department of Oncology; University of Turin at San Luigi Hospital; Turin Italy
| | - Milena Rondón-Lagos
- Escuela de Ciencias Biológicas; Universidad Pedagógica y Tecnológica de Colombia; Tunja Colombia
| | - Elisabetta Casalone
- Department of Medical Sciences; University of Turin; Turin Italy
- Italian Institute for Genomic Medicine; Turin Italy
| | | | - Paola Ogliara
- Medical Genetics Unit; AOU Città della Salute e della Scienza; Turin Italy
| | - Paolo Bironzo
- Department of Oncology; University of Turin; Turin Italy
| | - C. Laura Gironi
- Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Paola Savoia
- Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Antonella Maffè
- Molecular Genetics and Biology Unit; Santa Croce e Carle Hospital; Cuneo Italy
| | - Silvana Ungari
- Molecular Genetics and Biology Unit; Santa Croce e Carle Hospital; Cuneo Italy
| | - Federica Grosso
- Division of Medical Oncology; SS. Antonio e Biagio General Hospital; Alessandria Italy
| | - Roberta Libener
- Pathology Unit; SS. Antonio e Biagio General Hospital; Alessandria Italy
| | - Renzo Boldorini
- Department of Health Sciences, Section of Pathological Anatomy; University of Piemonte Orientale; Novara Italy
| | - Michele Valiante
- Clinical Genetics Unit, AO San Camillo-Forlanini; University La Sapienza; Rome Italy
| | - Barbara Pasini
- Medical Genetics Unit; AOU Città della Salute e della Scienza; Turin Italy
| | - Giuseppe Matullo
- Department of Medical Sciences; University of Turin; Turin Italy
- Italian Institute for Genomic Medicine; Turin Italy
- Medical Genetics Unit; AOU Città della Salute e della Scienza; Turin Italy
| | | | - Corrado Magnani
- Department of Translational Medicine, Unit of Cancer Epidemiology, CPO-Piemonte; University of Piemonte Orientale; Novara Italy
| | - Irma Dianzani
- Department of Health Sciences; University of Piemonte Orientale; Novara Italy
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28
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Miglio U, Berrino E, Panero M, Ferrero G, Coscujuela Tarrero L, Miano V, Dell'Aglio C, Sarotto I, Annaratone L, Marchiò C, Comoglio PM, De Bortoli M, Pasini B, Venesio T, Sapino A. The expression of LINE1-MET chimeric transcript identifies a subgroup of aggressive breast cancers. Int J Cancer 2018; 143:2838-2848. [PMID: 30144023 DOI: 10.1002/ijc.31831] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/17/2018] [Accepted: 08/15/2018] [Indexed: 01/03/2023]
Abstract
Demethylation of the long interspersed nuclear element (LINE-1; L1) antisense promoter can result in transcription of neighboring sequences as for the L1-MET transcript produced by the L1 placed in the second intron of MET. To define the role of L1-MET, we investigated the sequence and the transcription of L1-MET in vitro models and heterogeneous breast cancers, previously reported to show other L1-derived transcripts. L1-MET expressing cell lines were initially identified in silico and investigated for L1-MET promoter methylation, cDNA sequence and cell fraction mRNA. The transcriptional level of L1-MET and MET were then evaluated in breast specimens, including 9 cancer cell lines, 41 carcinomas of different subtypes, and 11 normal tissues. In addition to a L1-MET transcript ending at MET exon 21, six novel L1-MET splice variants were identified. Normal breast tissues were negative for the L1-MET expression, whereas the triple-negative breast cancer (TNBC) and the high-grade carcinomas were enriched with the L1-MET mRNA (p = 0.005 and p = 0.018, respectively). In cancer cells and tissues the L1-MET expression was associated with its promoter hypomethylation (ρ = -0.8 and -0.9, respectively). No correlation was found between L1-MET and MET mRNA although L1-MET expressing tumors with higher L1-MET/MET ratio were negative for the MET protein expression (p = 0.006). Besides providing the first identification and detailed description of L1-MET in breast cancer, we clearly demonstrate that higher levels of this transcript specifically recognize a subset of more aggressive carcinomas, mainly TNBC. We suggest the possible evaluation of L1-MET in the challenging diagnosis of early TNBCs.
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Affiliation(s)
- Umberto Miglio
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Enrico Berrino
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Mara Panero
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Giulio Ferrero
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.,Department of Computer Science, University of Turin, Turin, Italy
| | | | - Valentina Miano
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Carmine Dell'Aglio
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Ivana Sarotto
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Caterina Marchiò
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo M Comoglio
- Molecular Therapeutics and Exploratory Research Laboratory, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Michele De Bortoli
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Tiziana Venesio
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Anna Sapino
- Unit of Pathology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
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29
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Gironi LC, Colombo E, Pasini B, Giorgione R, Farinelli P, Zottarelli F, Esposto E, Zavattaro E, Allara E, Ogliara P, Betti M, Dianzani I, Savoia P. Melanoma-prone families: new evidence of distinctive clinical and histological features of melanomas in CDKN2A mutation carriers. Arch Dermatol Res 2018; 310:769-784. [PMID: 30218143 DOI: 10.1007/s00403-018-1866-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/30/2018] [Accepted: 09/08/2018] [Indexed: 11/26/2022]
Abstract
Germline mutations on the CDKN2A gene, the most important known genetic factors associated with cutaneous melanomas (CMs), predispose carriers to multiple primary CMs (MPMs) with higher frequency and younger onset compared to non-carriers. Most of the largest published studies concerning clinical and histological characteristics of CMs with CDKN2A mutation carriers did not specify if the described CMs are first or subsequent to the first, and they used sporadic CMs from non-genotyped patients as controls. We conducted a single-centre observational study to compare clinical and histological CM features of 32 unrelated carriers (MUT) of 5 germline CDKN2A mutations (one of which was never previously described) compared to 100 genotyped wild-type (WT) patients. We stratified the data based on time of diagnosis, anatomical site and histological subtype of CMs, demonstrating several significant unreported differences between the two groups. MUT developed a higher number of dysplastic nevi and MPMs. We proved for the first time that anatomical distribution of CMs in MUT was independent of gender, unlike WTs. MUTs developed in situ and superficial spreading melanomas (SSMs) more frequently, with significantly higher number of SSMs on the head/neck. In MUTs, Breslow thickness was significantly lower for all invasive CMs. When CMs were stratified on the basis of the time of occurrence, statistical significance was maintained only for SSMs subsequent to the first. In WTs, Clark level was significantly higher, and ulceration was more prevalent than in MUTs. Significant differences in ulceration were observed only in SSMs. In nodular CMs, we did not find differences in terms of Breslow thickness or ulceration between WTs and MUTs. In situ CMs developed 10 years earlier in MUTs with respect to WTs, whereas no significant differences were observed in invasive CMs. In contrast to those reported previously by other authors, we did not find a difference in skin phototype.
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Affiliation(s)
- Laura Cristina Gironi
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
| | - Enrico Colombo
- Department of Translational Medicine, A. Avogadro University of Eastern Piedmont, Novara, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberto Giorgione
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Pamela Farinelli
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Francesca Zottarelli
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elia Esposto
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elisa Zavattaro
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elias Allara
- NIHR Blood and Transplant Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paola Ogliara
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Marta Betti
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Irma Dianzani
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Paola Savoia
- Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
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30
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Rebbeck TR, Friebel TM, Friedman E, Hamann U, Huo D, Kwong A, Olah E, Olopade OI, Solano AR, Teo SH, Thomassen M, Weitzel JN, Chan TL, Couch FJ, Goldgar DE, Kruse TA, Palmero EI, Park SK, Torres D, van Rensburg EJ, McGuffog L, Parsons MT, Leslie G, Aalfs CM, Abugattas J, Adlard J, Agata S, Aittomäki K, Andrews L, Andrulis IL, Arason A, Arnold N, Arun BK, Asseryanis E, Auerbach L, Azzollini J, Balmaña J, Barile M, Barkardottir RB, Barrowdale D, Benitez J, Berger A, Berger R, Blanco AM, Blazer KR, Blok MJ, Bonadona V, Bonanni B, Bradbury AR, Brewer C, Buecher B, Buys SS, Caldes T, Caliebe A, Caligo MA, Campbell I, Caputo S, Chiquette J, Chung WK, Claes KB, Collée JM, Cook J, Davidson R, de la Hoya M, De Leeneer K, de Pauw A, Delnatte C, Diez O, Ding YC, Ditsch N, Domchek SM, Dorfling CM, Velazquez C, Dworniczak B, Eason J, Easton DF, Eeles R, Ehrencrona H, Ejlertsen B, Engel C, Engert S, Evans DG, Faivre L, Feliubadaló L, Ferrer SF, Foretova L, Fowler J, Frost D, Galvão HCR, Ganz PA, Garber J, Gauthier-Villars M, Gehrig A, Gerdes AM, Gesta P, Giannini G, Giraud S, Glendon G, Godwin AK, Greene MH, Gronwald J, Gutierrez-Barrera A, Hahnen E, Hauke J, Henderson A, Hentschel J, Hogervorst FB, Honisch E, Imyanitov EN, Isaacs C, Izatt L, Izquierdo A, Jakubowska A, James P, Janavicius R, Jensen UB, John EM, Joseph V, Kaczmarek K, Karlan BY, Kast K, Kim SW, Konstantopoulou I, Korach J, Laitman Y, Lasa A, Lasset C, Lázaro C, Lee A, Lee MH, Lester J, Lesueur F, Liljegren A, Lindor NM, Longy M, Loud JT, Lu KH, Lubinski J, Machackova E, Manoukian S, Mari V, Martínez-Bouzas C, Matrai Z, Mebirouk N, Meijers-Heijboer HE, Meindl A, Mensenkamp AR, Mickys U, Miller A, Montagna M, Moysich KB, Mulligan AM, Musinsky J, Neuhausen SL, Nevanlinna H, Ngeow J, Nguyen HP, Niederacher D, Nielsen HR, Nielsen FC, Nussbaum RL, Offit K, Öfverholm A, Ong KR, Osorio A, Papi L, Papp J, Pasini B, Pedersen IS, Peixoto A, Peruga N, Peterlongo P, Pohl E, Pradhan N, Prajzendanc K, Prieur F, Pujol P, Radice P, Ramus SJ, Rantala J, Rashid MU, Rhiem K, Robson M, Rodriguez GC, Rogers MT, Rudaitis V, Schmidt AY, Schmutzler RK, Senter L, Shah PD, Sharma P, Side LE, Simard J, Singer CF, Skytte AB, Slavin TP, Snape K, Sobol H, Southey M, Steele L, Steinemann D, Sukiennicki G, Sutter C, Szabo CI, Tan YY, Teixeira MR, Terry MB, Teulé A, Thomas A, Thull DL, Tischkowitz M, Tognazzo S, Toland AE, Topka S, Trainer AH, Tung N, van Asperen CJ, van der Hout AH, van der Kolk LE, van der Luijt RB, Van Heetvelde M, Varesco L, Varon-Mateeva R, Vega A, Villarreal-Garza C, von Wachenfeldt A, Walker L, Wang-Gohrke S, Wappenschmidt B, Weber BHF, Yannoukakos D, Yoon SY, Zanzottera C, Zidan J, Zorn KK, Hutten Selkirk CG, Hulick PJ, Chenevix-Trench G, Spurdle AB, Antoniou AC, Nathanson KL. Mutational spectrum in a worldwide study of 29,700 families with BRCA1 or BRCA2 mutations. Hum Mutat 2018; 39:593-620. [PMID: 29446198 PMCID: PMC5903938 DOI: 10.1002/humu.23406] [Citation(s) in RCA: 189] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/09/2018] [Accepted: 01/19/2018] [Indexed: 01/19/2023]
Abstract
The prevalence and spectrum of germline mutations in BRCA1 and BRCA2 have been reported in single populations, with the majority of reports focused on White in Europe and North America. The Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) has assembled data on 18,435 families with BRCA1 mutations and 11,351 families with BRCA2 mutations ascertained from 69 centers in 49 countries on six continents. This study comprehensively describes the characteristics of the 1,650 unique BRCA1 and 1,731 unique BRCA2 deleterious (disease-associated) mutations identified in the CIMBA database. We observed substantial variation in mutation type and frequency by geographical region and race/ethnicity. In addition to known founder mutations, mutations of relatively high frequency were identified in specific racial/ethnic or geographic groups that may reflect founder mutations and which could be used in targeted (panel) first pass genotyping for specific populations. Knowledge of the population-specific mutational spectrum in BRCA1 and BRCA2 could inform efficient strategies for genetic testing and may justify a more broad-based oncogenetic testing in some populations.
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Affiliation(s)
- Timothy R. Rebbeck
- Harvard TH Chan School of Public Health and Dana Farber Cancer Institute, 1101 Dana Building, 450 Brookline Ave, Boston, MA 02215, USA
| | - Tara M. Friebel
- Harvard TH Chan School of Public Health and Dana Farber Cancer Institute, 1101 Dana Building, 450 Brookline Ave, Boston, MA 02215, USA
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan 52621, and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
| | - Dezheng Huo
- 5841 South Maryland Avenue, MC 2115 Chicago, IL, USA
| | - Ava Kwong
- The Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Hong Kong
| | - Edith Olah
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | | | - Angela R. Solano
- INBIOMED, Faculty of Medicine, University of Buenos Aires/CONICET and CEMIC, Department of Clinical Chemistry, Medical Direction, Buenos Aires, Paraguay 2155, C1121ABG, Argentina
| | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Malaysia
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense C, Denmark
| | - Jeffrey N. Weitzel
- Clinical Cancer Genetics, City of Hope, 1500 East Duarte Road, Duarte, California 91010 USA
| | - TL Chan
- Division of Molecular Pathology, Department of Pathology, Hong Kong Sanatorium & Hospital, 1/F Li Shu Fan Block, 2 Village Road, Happy Valley, Hong Kong
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, and Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, USA
| | - David E. Goldgar
- Department of Dermatology, University of Utah School of Medicine, 30 North 1900 East, SOM 4B454, Salt Lake City, UT 84132, USA
| | - Torben A. Kruse
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense C, Denmark
| | - Edenir Inêz Palmero
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Sue Kyung Park
- 1) Department of Preventive Medicine, Seoul National University College of Medicine; 2) Department of Biomedical Science, Seoul National University Graduate School; 3) Cancer Research Center, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Korea
| | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
- Institute of Human Genetics, Pontificia Universidad Javeriana, Carrera 7, Bogota, 11001000, Colombia
| | - Elizabeth J. van Rensburg
- Cancer Genetics Laboratory, Department of Genetics, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | - Michael T. Parsons
- Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Herston Road, Brisbane, QLD 4006, Australia
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | - Cora M. Aalfs
- Department of Clinical Genetics, Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands
| | - Julio Abugattas
- City of Hope Clinical Cancer Genomics Community Research Network, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
| | - Simona Agata
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata 64, Padua, Italy
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Hospital, P.O. BOX 160 (Meilahdentie 2), 00029 HUS, Finland
| | - Lesley Andrews
- Hereditary Cancer Clinic, Prince of Wales Hospital, High Street, Randwick, NSW 2031 Australia
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario M5G 1X5, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Ontario
| | - Adalgeir Arason
- Department of Pathology, hus 9, Landspitali-LSH v/Hringbraut, 101 Reykjavik, Iceland
| | - Norbert Arnold
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Germany
| | - Banu K. Arun
- Department of Breast Medical Oncology and Clinical Cancer Genetics Program, University Of Texas MD Anderson Cancer Center, 1515 Pressler Street, CBP 5, Houston, TX, USA
| | - Ella Asseryanis
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria, Waehringer Guertel 18-20, A 1090 Vienna, Austria
| | - Leo Auerbach
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria, Waehringer Guertel 18-20, A 1090 Vienna, Austria
| | - Jacopo Azzollini
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) Instituto Nazionale Tumori (INT), Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Judith Balmaña
- Department of Medical Oncology. University Hospital, Vall d'Hebron, Barcelona, Spain
| | - Monica Barile
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Rosa B. Barkardottir
- Laboratory of Cell Biology, Department of Pathology, hus 9, Landspitali-LSH v/Hringbraut, 101 Reykjavik, Iceland and BMC (Biomedical Centre), Faculty of Medicine, University of Iceland, Vatnsmyrarvegi 16, 101 Reykjavik, Iceland
| | - Daniel Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | - Javier Benitez
- Human Genetics Group and Genotyping Unit (CEGEN), Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain. Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Andreas Berger
- Dept of OB/GYN, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Raanan Berger
- The Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan 52621, Israel
| | - Amie M. Blanco
- UCSF Cancer Genetics and Prevention Program, San Francisco, CA 94143-1714
| | - Kathleen R. Blazer
- Clinical Cancer Genetics, City of Hope, 1500 East Duarte Road, Duarte, California 91010 USA
| | - Marinus J. Blok
- Department of Clinical Genetics, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Valérie Bonadona
- Unité de Prévention et d’Epidémiologie Génétique, Centre Léon Bérard, 28 rue Laënnec, Lyon, France
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Angela R. Bradbury
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, UK
| | - Bruno Buecher
- Service de Génétique, Institut Curie, 26, rue d’Ulm, Paris Cedex 05, France
| | - Saundra S. Buys
- Department of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112, USA
| | - Trinidad Caldes
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC. Martin Lagos s/n, Madrid, Spain
| | - Almuth Caliebe
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Germany
| | - Maria A. Caligo
- Section of Genetic Oncology, Dept. of Laboratory Medicine, University and University Hospital of Pisa, Pisa, Italy
| | - Ian Campbell
- Research Division, Peter MacCallum Cancer Centre, 305 Gratten Street, Melbourne, VIC 3000, Australia
| | - Sandrine Caputo
- Service de Génétique, Institut Curie, 26, rue d’Ulm, Paris Cedex 05, France
| | - Jocelyne Chiquette
- CRCHU de Quebec-oncologie, Centre des maladies du sein Deschênes-Fabia, Hôpital du Saint-Sacrement,1050, chemin Sainte-Foy, Québec Canada
| | - Wendy K. Chung
- Departments of Pediatrics and Medicine, 1150 St. Nicholas Avenue, Columbia University, New York, NY, 10032 USA
| | - Kathleen B.M. Claes
- Center for Medical Genetics, Ghent University, De Pintelaan 185, 9000 Gent, Belgium
| | - J. Margriet Collée
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children’s Hospital, Sheffield, UK
| | - Rosemarie Davidson
- Department of Clinical Genetics, South Glasgow University Hospitals, Glasgow, UK
| | - Miguel de la Hoya
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC. Martin Lagos s/n, Madrid, Spain
| | - Kim De Leeneer
- Center for Medical Genetics, Ghent University, De Pintelaan 185, 9000 Gent, Belgium
| | - Antoine de Pauw
- Service de Génétique, Institut Curie, 26, rue d’Ulm, Paris Cedex 05, France
| | - Capucine Delnatte
- Unité d'oncogénétique, ICO-Centre René Gauducheau, Boulevard Jacques Monod, 44805 Nantes Saint Herblain Cedex, France
| | - Orland Diez
- Oncogenetics Group, Vall d’Hebron Institute of Oncology (VHIO), Clinical and Molecular Genetics Area, Vall d’Hebron University Hospital, Passeig Vall d'Hebron 119-129, Barcelona, Spain
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA USA
| | - Nina Ditsch
- Department of Gynaecology and Obstetrics, Ludwig-Maximilian University Munich, Germany
| | - Susan M. Domchek
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Cecilia M. Dorfling
- Cancer Genetics Laboratory, Department of Genetics, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
| | - Carolina Velazquez
- Cáncer Hereditario, Instituto de Biología y Genética Molecular, IBGM, Universidad de Valladolid, Centro Superior de Investigaciones Científicas, UVA-CSIC. Valladolid, Spain
| | - Bernd Dworniczak
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - Jacqueline Eason
- Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | - Ros Eeles
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Hans Ehrencrona
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden
| | - Bent Ejlertsen
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - EMBRACE
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany
| | - Stefanie Engert
- Department of Gynaecology and Obstetrics, Division of Tumor Genetics, Klinikum rechts der Isar, Technical University Munich, Germany
| | - D. Gareth Evans
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, University of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Laurence Faivre
- Centre de Lutte Contre le Cancer Georges François Leclerc, 1 rue Professeur Marion, BP 77 980, Dijon Cedex, France and Genomic and Immunotherapy Medical Institute, Dijon University Hospital, Dijon, France
| | - Lidia Feliubadaló
- Molecular Diagnostic Unit, Hereditary Cancer Program, ICO-IDIBELL (Catalan Institute of Oncology-Bellvitge Biomedical Research Institute), CIBERONC, Gran Via de l'Hospitalet, 199-203. 08908 L'Hospitalet. Barcelona, Spain
| | - Sandra Fert Ferrer
- Laboratoire de Génétique Chromosomique, Hôtel Dieu Centre Hospitalier, BP 1125 Chambéry, France
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, 65653, Czech Republic
| | - Jeffrey Fowler
- Ohio State University /Columbus Cancer Council, Columbus, OH 43221, USA
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - Patricia A. Ganz
- UCLA Schools of Medicine and Public Health, Division of Cancer Prevention & Control Research, Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, Room A2-125 HS, Los Angeles, CA 90095-6900, USA
| | - Judy Garber
- Cancer Risk and Prevention Clinic, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA
| | | | - Andrea Gehrig
- Centre of Familial Breast and Ovarian Cancer, Department of Medical Genetics, Institute of Human Genetics, University Würzburg, Germany
| | - GEMO Study Collaborators
- Institut Curie, Department of Tumour Biology, Paris, France; Institut Curie, INSERM U830, Paris, France
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet 4062, Blegdamsvej 9, København Ø, Denmark
| | - Paul Gesta
- Service Régional Oncogénétique Poitou-Charentes, Centre Hospitalier, 79021 Niort
| | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, and Istituto Pasteur - Fondazione Cenci-Bolognetti, viale Regina Elena 291, 00161 Rome, Italy
| | - Sophie Giraud
- Bâtiment Cheney D, Centre Léon Bérard, 28 rue Laënnec, Lyon, France
| | - Gord Glendon
- Ontario Cancer Genetics Network: Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario M5G 1X5, Canada
| | - Andrew K. Godwin
- Department of Pathology and Laboratory Medicine, 3901 Rainbow Boulevard,4019 Wahl Hall East, MS 3040, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mark H. Greene
- Clinical Genetics Branch, DCEG, NCI, NIH, 9609 Medical Center Drive, Room 6E-454, Bethesda, MD, USA
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Angelica Gutierrez-Barrera
- Department of Breast Medical Oncology and Clinical Cancer Genetics Program, University Of Texas MD Anderson Cancer Center, 1515 Pressler Street, CBP 5, Houston, TX, USA
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Jan Hauke
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - HEBON
- The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating center: Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Alex Henderson
- Institute of Genetic Medicine, Centre for Life, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Julia Hentschel
- Institute of Human Genetics, University Leipzig, 04107 Leipzig, Germany
| | - Frans B.L. Hogervorst
- Family Cancer Clinic, Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Ellen Honisch
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Germany
| | | | - Claudine Isaacs
- Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Road NW, Washington, DC, USA
| | - Louise Izatt
- Clinical Genetics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Angel Izquierdo
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBGI (Institut d'Investigació Biomèdica de Girona), Catalan Institute of Oncology, CIBERONC, Av. França s/n. 1707 Girona, Spain
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Paul James
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, 305 Gratten Street, Melbourne, VIC 3000, Australia
| | - Ramunas Janavicius
- Vilnius University Hospital Santariskiu Clinics, Hereditary Cancer Competence Center Hematology, Oncology and Transfusion Medicine Center Room P519 Santariskiu st. 2, LT-08661 Vilnius, Lithuania
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus N, Denmark
| | - Esther M. John
- Department of Epidemiology, Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA and Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Vijai Joseph
- Clinical Genetics Research Laboratory, Dept. of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10044, USA
| | - Katarzyna Kaczmarek
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Beth Y. Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290W, Los Angeles, CA, USA
| | - Karin Kast
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - KConFab Investigators
- Research Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia and The Sir Peter MacCallum Department of Oncology University of Melbourne, Parkville, Australia
| | - Sung-Won Kim
- Department of Surgery, Daerim St. Mary's Hospital, 657 Siheung-daero, Yeongdeungpo-gu, Seoul, Korea
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRASTES (Institute of Nuclear and Radiological Sciences and Technology), National Centre for Scientific Research "Demokritos", Patriarchou Gregoriou & Neapoleos str., Aghia Paraskevi Attikis, Athens, Greece
| | - Jacob Korach
- The Gyneco-Oncology Department, Chaim Sheba Medical Center, Ramat Gan 52621, Israel
| | - Yael Laitman
- The Susanne Levy Gertner Oncogenetics Unit, Institute of Human Genetics, Chaim Sheba Medical Center, Ramat Gan 52621, and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adriana Lasa
- Servicio de Genética-CIBERER U705, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - Christine Lasset
- Unité de Prévention et d’Epidémiologie Génétique, Centre Léon Bérard, 28 rue Laënnec, Lyon, France
| | - Conxi Lázaro
- Molecular Diagnostic Unit, Hereditary Cancer Program, ICO-IDIBELL (Catalan Institute of Oncology-Bellvitge Biomedical Research Institute), CIBERONC, Gran Via de l'Hospitalet, 199-203. 08908 L'Hospitalet. Barcelona, Spain
| | - Annette Lee
- The Feinstein Institute for Medical Research 350 Community Drive Manhasset NY
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University and Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, Korea
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290W, Los Angeles, CA, USA
| | - Fabienne Lesueur
- Institut Curie, PSL Research University, Mines ParisTech, Inserm U900, 26 rue d'Ulm, F-75005 Paris, France
| | - Annelie Liljegren
- Department of Oncology Radiumhemmet and Institution of Oncology and Patology, Karolinska University Hospital and Karolinska Institutet
| | - Noralane M. Lindor
- Department of Health Sciences Research, Mayo Clinic, 13400 E. Scottsdale Blvd., Scottsdale, AZ, USA
| | - Michel Longy
- Oncogénétique, Institut Bergonié, 229 cours de l'Argonne, 33076 Bordeaux, France
| | - Jennifer T. Loud
- Clinical Genetics Branch, DCEG, NCI, NIH, 9609 Medical Center Drive, Room 6E-536, Bethesda, MD, USA
| | - Karen H. Lu
- Department of Gynecological Oncology and Clinical Cancer Genetics Program, University Of Texas MD Anderson Cancer Center, 1515 Pressler Street, CPB 6, Houston, TX, USA
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Eva Machackova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, 65653, Czech Republic
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) Instituto Nazionale Tumori (INT), Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Véronique Mari
- Centre Antoine Lacassagne, 33 Avenue de Valombrose, Nice, France
| | - Cristina Martínez-Bouzas
- Laboratorio de Genética Molecular, Servicio de Genética, Hospital Universitario Cruces, BioCruces Health Research Institute, Spain
| | - Zoltan Matrai
- Department of Surgery, National Institute of Oncology, Budapest, Hungary
| | - Noura Mebirouk
- Institut Curie, PSL Research University, Mines ParisTech, Inserm U900, 26 rue d'Ulm, F-75005 Paris, France
| | - Hanne E.J. Meijers-Heijboer
- Department of Clinical Genetics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Alfons Meindl
- Department of Gynaecology and Obstetrics, Division of Tumor Genetics, Klinikum rechts der Isar, Technical University Munich, Germany
| | - Arjen R. Mensenkamp
- Department of Human Genetics, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Ugnius Mickys
- Vilnius university Santariskiu hospital, National Center of Pathology, Baublio st. 5, Vilnius, Lithuania
| | - Austin Miller
- NRG Oncology, Statistics and Data Management Center, Roswell Park Cancer Institute, Elm St & Carlton St, Buffalo, NY 14263, USA
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata 64, Padua, Italy
| | - Kirsten B. Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Jacob Musinsky
- Clinical Genetics Research Laboratory, Dept. of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10044, USA
| | - Susan L. Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA USA
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Biomedicum Helsinki, P.O. BOX 700 (Haartmaninkatu 8), 00029 HUS, Finland
| | - Joanne Ngeow
- Cancer Genetics Service, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610
| | - Huu Phuc Nguyen
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Germany
| | - Dieter Niederacher
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Germany
| | - Henriette Roed Nielsen
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense C, Denmark
| | - Finn Cilius Nielsen
- Center for Genomic Medicine, Rigshospitalet, University of Copenhagen, Denmark
| | | | - Kenneth Offit
- Clinical Genetics Research Laboratory, Dept. of Medicine, Cancer Biology and Genetics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10044, USA
| | - Anna Öfverholm
- Department of Clinical Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kai-ren Ong
- West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham, UK
| | - Ana Osorio
- Human Genetics Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain. Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Laura Papi
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Janos Papp
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Via Santena 19, 10126 Turin, Italy
| | - Inge Sokilde Pedersen
- Section of Molecular Diagnostics, Department of Biochemistry, Aalborg University Hospital, Reberbansgade 15, Aalborg, Denmark
| | - Ana Peixoto
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal, and Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Nina Peruga
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Paolo Peterlongo
- IFOM, The FIRC (Italian Foundation for Cancer Research) Institute of Molecular Oncology, via Adamello 16, 20139 Milan, Italy
| | - Esther Pohl
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Nisha Pradhan
- Clinical Genetics Research Laboratory, Dept. of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10044, USA
| | - Karolina Prajzendanc
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Fabienne Prieur
- Service de Génétique Clinique Chromosomique et Moléculaire, Hôpital Nord, CHU Saint Etienne, St Etienne cedex 2, France
| | - Pascal Pujol
- Unité d'Oncogénétique, CHU Arnaud de Villeneuve, 34295 Montpellier Cedex 5, France
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale Tumori (INT), c/o Amaedeolab, via GA Amadeo 42, 20133 Milan, Italy
| | - Susan J. Ramus
- School of Women's and Children's Health, UNSW Sydney, Australia
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Australia
| | - Johanna Rantala
- Department of Clinical Genetics, Karolinska University Hospital L5:03, Stockholm S-171 76, Sweden
| | - Muhammad Usman Rashid
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120 Heidelberg, Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC) 7A, Block R3, Johar Town, Lahore, Punjab 54000, Pakistan
| | - Kerstin Rhiem
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Mark Robson
- Clinical Genetics Services, Dept. of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, USA
| | - Gustavo C. Rodriguez
- Division of Gynecologic Oncology, North Shore University Health System, Clinical Professor, University of Chicago, 2650 Ridge Avenue, Suite 1507 Walgreens, Evanston, IL 60201, USA
| | - Mark T. Rogers
- All Wales Medical Genetics Services, University Hospital of Wales, Cardiff, UK
| | - Vilius Rudaitis
- Vilnius University Hospital Santariskiu Clinics, Centre of Woman's Health and pathology, Department of Gynecology, Santariskiu st. 2, Vilnius, Lithuania
| | - Ane Y. Schmidt
- Center for Genomic Medicine, Rigshospitalet, University of Copenhagen, Denmark
| | - Rita Katharina Schmutzler
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Leigha Senter
- Clinical Cancer Genetics Program, Division of Human Genetics, Department of Internal Medicine, The Comprehensive Cancer Center, The Ohio State University, Columbus, USA
| | - Payal D. Shah
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Priyanka Sharma
- Department of Hematology and Oncology, University of Kansas Medical Center, Suite 210, 2330 Shawnee Mission Parkway, Westwood, KS, USA
| | - Lucy E. Side
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec Research Center and Laval University, 2705 Laurier Boulevard, Quebec City (Quebec), Canada
| | - Christian F. Singer
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria, Waehringer Guertel 18-20, A 1090 Vienna, Austria
| | - Anne-Bine Skytte
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus N, Denmark
| | - Thomas P. Slavin
- Clinical Cancer Genetics, City of Hope, 1500 East Duarte Road, Duarte, California 91010 USA
| | - Katie Snape
- Medical Genetics Unit, St George's, University of London, UK
| | - Hagay Sobol
- Département Oncologie Génétique, Prévention et Dépistage, Institut Paoli-Calmettes, 232 boulevard Sainte-Margueritte, Marseille, France
| | - Melissa Southey
- Département Oncologie Génétique, Prévention et Dépistage, Institut Paoli-Calmettes, 232 boulevard Sainte-Margueritte, Marseille, France
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA USA
| | - Doris Steinemann
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | - Grzegorz Sukiennicki
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | - Christian Sutter
- Department of Human Genetics, University Hospital Heidelberg, Germany
| | - Csilla I. Szabo
- National Human Genome Research Institute, National Institutes of Health Building 50, Room 5312, 50 South Drive, MSC 004, Bethesda, MD, USA
| | - Yen Y. Tan
- Dept of OB/GYN, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Manuel R. Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal, and Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Alex Teulé
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Gran Via de l'Hospitalet, 199-203. 08908 L'Hospitalet, Barcelona, Spain
| | - Abigail Thomas
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, USA
| | - Darcy L. Thull
- Department of Medicine, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marc Tischkowitz
- Program in Cancer Genetics, Departments of Human Genetics and Oncology, McGill University, Montreal, Quebec, Canada
| | - Silvia Tognazzo
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata 64, Padua, Italy
| | - Amanda Ewart Toland
- Division of Human Genetics, Departments of Internal Medicine and Cancer Biology and Genetics, Comprehensive Cancer Center, The Ohio State University, 460 W. 12 Avenue, Columbus, OH, USA
| | - Sabine Topka
- Clinical Genetics Research Laboratory, Dept. of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10044, USA
| | - Alison H Trainer
- Parkville Familial Cancer Centre, Royal Melbourne Hospital, Melbourne, Australia
| | - Nadine Tung
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue Boston, Massachusetts 02215, USA
| | - Christi J. van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | | | | | - Rob B. van der Luijt
- Department of Medical Genetics, University Medical Center Utrecht, The Netherlands
| | | | - Liliana Varesco
- Unit of Hereditary Cancer, Department of Epidemiology, Prevention and Special Functions, IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, largo Rosanna Benzi 10, 16132 Genoa, Italy
| | | | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, calle Choupana s/n, Edificio de Consultas, Planta menos dos Santiago de Compostal, A Coruña, Spain
| | - Cynthia Villarreal-Garza
- Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City; and Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon
| | | | - Lisa Walker
- Oxford Regional Genetics Service, Churchill Hospital, Oxford, UK
| | - Shan Wang-Gohrke
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Germany
| | - Barbara Wappenschmidt
- Department of Genetics and Pathology, Pomeranian Medical University, Unii Lubelskiej 1, Szczecin, Poland
| | | | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES (Institute of Nuclear and Radiological Sciences and Technology), National Centre for Scientific Research "Demokritos", Patriarchou Gregoriou & Neapoleos str., Aghia Paraskevi Attikis, Athens, Greece
| | - Sook-Yee Yoon
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS12/1A, Subang Jaya, 47500, Malaysia
| | - Cristina Zanzottera
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) Instituto Nazionale Tumori (INT), Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Jamal Zidan
- Institute of Oncology, Rivka Ziv Medical Center, 13000 Zefat, Israel
| | - Kristin K. Zorn
- Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christina G. Hutten Selkirk
- Center for Medical Genetics, NorthShore University HealthSystem,1000 Central St, Suite 620, Evanston, IL, USA
| | - Peter J. Hulick
- Medical Director, Center for Medical Genetics, North Shore University Health System, Clinical Assistant Professor of Medicine, University of Chicago Pritzker School of Medicine, 1000 Central Street, Suite 620, Evanston, IL 60201, USA
| | - Georgia Chenevix-Trench
- Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Herston Road, Brisbane, QLD 4006, Australia
| | - Amanda B. Spurdle
- Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Herston Road, Brisbane, QLD 4006, Australia
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | - Katherine L. Nathanson
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Scopsi L, Castellani MR, Gullo M, Cusumano F, Camerini E, Pasini B, Orefice S. Malignant Pheochromocytoma in Multiple Endocrine Neoplasia Type 2B Syndrome. Case Report and Review of the Literature. Tumori 2018; 82:480-4. [PMID: 9063528 DOI: 10.1177/030089169608200514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A malignant behavior (i.e., distant metastatic spread) has been recorded in 3-4% of pheochromocytomas occurring in the context of multiple endocrine neoplasia type 2A syndrome, but has never been documented in patients with the type 2B form. In this report we describe a case of malignant pheochromocytoma arising in the latter syndrome setting. The patient, a white young male, had the full-blown syndrome, including multicentric, bilateral medullary thyroid carcinoma metastatic to regional lymph nodes, mucosal neuromas, digestive ganglioneuromatosis, marfanoid habitus, and bumpy lips. Three and a half years after surgical resection of an apparently benign adrenal pheochromocytoma he developed widespread osseous metastases. The presence of hypertensive crises and high urinary catecholamine excretion rates, coupled to moderate hypercalcitoninemia, normal circulating carcinoembryonic antigen levels, negative whole-body 99mTc-(V) dimercaptosuccinic acid scan, and absence of neck or mediastinal disease by magnetic resonance imaging, proved that the metastases were from his previous adrenal and not thyroid tumor. Furthermore, since the bone metastases strongly accumulated 131I-metaiodobenzylguanidine, several courses of the radiocompound were given, which resulted in an objective, though partial, tumor regression.
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Affiliation(s)
- L Scopsi
- Endocrinology Unit, Istituto Nazionale Tumori, Milan, Italy.
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Trecate G, Vergnaghi D, Bergonzi S, De Simone T, Fengoni E, Costa C, Spatti G, Pasini B, Manoukian S, Podo F, Musumeci R. Breast MRI Screening in Patients with Increased Familial and/or Genetic Risk for Breast Cancer: A Preliminary Experience. Tumori 2018; 89:125-31. [PMID: 12841657 DOI: 10.1177/030089160308900204] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Aims and background Breast cancer is the most common cancer affecting women, and it is associated with or due to a genetic predisposition in 5%-10% of the cases. Owing to the higher risk of developing breast cancer and the early onset of the disease in women proved or suspected to be carriers of a breast cancer susceptibility gene, a dedicated screening should be offered as a less invasive approach with the otherwise suggested prophylactic mastectomy. This should be optimized in order to overcome the limitations of conventional breast imaging with the application of new technologies such as breast magnetic resonance imaging. Methods A diagnostic protocol for routine control in patients at high risk of developing breast cancer has been prepared. Within a 7-month period, 23 patients suspected or proved to carry a breast cancer susceptibility gene underwent breast magnetic resonance imaging. Results Four breast cancers were identified with breast magnetic resonance imaging. In these cases, mammography was negative because of the density of the parenchyma or for its fibroglandular pattern. Ultrasound was negative in 2 cases, not specific for malignancy in 1 case, and considered as only possibly malignant but with biopsy recommendation on the basis of magnetic resonance findings in the last one. Clinical analysis was positive for a mass in 2 cases. Conclusions The accuracy of breast magnetic resonance imaging is known to be higher than that of conventional imaging in the study of breast parenchyma. High spatial resolution, no breast density influence and multiplanarity can give more detailed information about the smaller lesions and the right extension of the disease. Preliminary studies where breast magnetic resonance imaging is performed in addition to mammography within this group of patients are encouraging. We also believe that the application of breast magnetic resonance imaging can be very useful in the detection of cancer as early as possible with the aim to obtain the highest chance of survival after treatment.
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Affiliation(s)
- Giovanna Trecate
- Unit of Diagnostic Radiology A, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
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Monticone S, Buffolo F, Tetti M, Veglio F, Pasini B, Mulatero P. GENETICS IN ENDOCRINOLOGY: The expanding genetic horizon of primary aldosteronism. Eur J Endocrinol 2018; 178:R101-R111. [PMID: 29348113 DOI: 10.1530/eje-17-0946] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/18/2018] [Indexed: 12/15/2022]
Abstract
Aldosterone is the main mineralocorticoid hormone in humans and plays a key role in maintaining water and electrolyte homeostasis. Primary aldosteronism (PA), characterized by autonomous aldosterone overproduction by the adrenal glands, affects 6% of the general hypertensive population and can be either sporadic or familial. Aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH) are the two most frequent subtypes of sporadic PA and 4 forms of familial hyperaldosteronism (FH-I to FH-IV) have been identified. Over the last six years, the introduction of next-generation sequencing has significantly improved our understanding of the molecular mechanisms responsible for autonomous aldosterone overproduction in both sporadic and familial PA. Somatic mutations in four genes (KCNJ5, ATP1A1, ATP2B3 and CACNA1D), differently implicated in intracellular ion homeostasis, have been identified in nearly 60% of the sporadic APAs. Germline mutations in KCNJ5 and CACNA1H cause FH-III and FH-IV, respectively, while germline mutations in CACNA1D cause the rare PASNA syndrome, featuring primary aldosteronism seizures and neurological abnormalities. Further studies are warranted to identify the molecular mechanisms underlying BAH and FH-II, the most common forms of sporadic and familial PA whose molecular basis is yet to be uncovered.
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Affiliation(s)
- Silvia Monticone
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Fabrizio Buffolo
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Martina Tetti
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Franco Veglio
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Barbara Pasini
- Division of Medical Genetics, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy
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Giorgio E, Rubino E, Bruselles A, Pizzi S, Rainero I, Duca S, Sirchia F, Pasini B, Tartaglia M, Brusco A. A syndromic extreme insulin resistance caused by biallelic POC1A mutations in exon 10. Eur J Endocrinol 2017; 177:K21-K27. [PMID: 28819016 DOI: 10.1530/eje-17-0431] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/27/2017] [Accepted: 08/17/2017] [Indexed: 11/08/2022]
Abstract
POC1A encodes a protein with a role in centriole assembly and stability, and in ciliogenesis. Biallelic loss-of-function mutations affecting POC1A cause SOFT syndrome, an ultra-rare condition characterized by short stature, onychodysplasia, facial dysmorphism and hypotrichosis. Using exome sequencing, we identified a homozygous frameshift mutation (c.1047_1048dupC; p.G337Rfs*25) in a patient presenting with short stature, facial hirsutism, alopecia, dyslipidemia and extreme insulin resistance. The truncating variant affected exon 10, which is retained in only two of the three POC1A-mature RNAs, due to alternative processing of the transcript. Clinical discrepancies with SOFT syndrome support the hypothesis that POC1A mutations affecting exon 10 are associated with a distinct condition, corroborating a previous hypothesis based on a similar case. Furthermore, this report provides an additional example of a genetic condition presenting with clinical heterogeneity due to alternative transcript processing. In conclusion, POC1A mutations in exon 10 should be taken into account in patients with extreme insulin resistance and short stature.
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Affiliation(s)
- Elisa Giorgio
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Elisa Rubino
- Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Torino, Italy
- Koelliker Hospital, Torino, Italy
| | - Alessandro Bruselles
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Simone Pizzi
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù IRCSS, Rome, Italy
| | - Innocenzo Rainero
- Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Torino, Italy
| | | | - Fabio Sirchia
- Department of Medical Sciences, University of Torino, Torino, Italy
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Torino, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Torino, Torino, Italy
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Torino, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù IRCSS, Rome, Italy
| | - Alfredo Brusco
- Department of Medical Sciences, University of Torino, Torino, Italy
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Torino, Italy
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Allasia M, Soria F, Battaglia A, Gazzera C, Calandri M, Caprino MP, Lucatello B, Velrti A, Maccario M, Pasini B, Bosio A, Gontero P, Destefanis P. Radiofrequency Ablation for Renal Cancer in Von Hippel-Lindau Syndrome Patients: A Prospective Cohort Analysis. Clin Genitourin Cancer 2017; 16:S1558-7673(17)30237-9. [PMID: 28866246 DOI: 10.1016/j.clgc.2017.07.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 07/27/2017] [Accepted: 07/31/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Management of renal-cell carcinoma (RCC) in patients with Von Hippel-Lindau syndrome (VHL) represents a clinical dilemma: the oncologic outcomes must be weighed against preservation of renal function. Radiofrequency ablation (RFA) is currently used in selected cases for treatment of small-size RCC. The aim of this study was to evaluate the safety, complications, and functional and oncologic outcomes of RFA in the treatment of RCC in VHL patients. PATIENTS AND METHODS RCCs were treated with ultrasound-guided RFA or with laparoscopic RFA. Clinical and radiologic response, disease recurrence, and survival outcomes were evaluated during follow-up. Early and late complications were recorded and graded. RESULTS Nine RCC patients underwent RFA. The median number of RCCs per patient was 3 (interquartile range, 2-4). Among these 9 patients, a total of 20 RCCs were treated by RFA (19 ultrasound-guided RFA and 1 laparoscopic procedure). Median RCC size was 2.5 cm (interquartile range, 2.0-3.0). RFA did not impair renal function (P = .35). In 2 cases disease persisted, and in 1 case disease recurred after 18 months. These patients were retreated with ultrasound-guided RFA with complete response and no renal function impairment. RFA treatment was overall well tolerated and safe. No complications were recorded. Postoperative stay was no longer than 1 day. CONCLUSION RCC occurred in about two-thirds of VHL patients, who had young age at presentation; it was frequently multifocal and recurrent. The use of RFA, with extended indications, could represent a tailored treatment for VHL patients, reducing the risk of renal failure and resulting in satisfying oncologic results.
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Affiliation(s)
- Marco Allasia
- Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy.
| | - Francesco Soria
- Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Antonino Battaglia
- Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Carlo Gazzera
- Department of Interventional Radiology and Diagnostic Imaging, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Marco Calandri
- Department of Interventional Radiology and Diagnostic Imaging, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Mirko Parasiliti Caprino
- Division of Endocrinology, Diabetology, and Metabolism, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Barbara Lucatello
- Division of Endocrinology, Diabetology, and Metabolism, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Andrea Velrti
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy
| | - Mario Maccario
- Division of Endocrinology, Diabetology, and Metabolism, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Barbara Pasini
- Department of Preventive and Predictive Medicine, Unit of Medical Genetics, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Andrea Bosio
- Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Paolo Gontero
- Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
| | - Paolo Destefanis
- Division of Urology, Department of Surgical Science, A. O. Città della Salute e Della Scienza di Torino-presidio Molinette, University of Turin, Turin, Italy
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36
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Di Gregorio E, Riberi E, Belligni EF, Biamino E, Spielmann M, Ala U, Calcia A, Bagnasco I, Carli D, Gai G, Giordano M, Guala A, Keller R, Mandrile G, Arduino C, Maffè A, Naretto VG, Sirchia F, Sorasio L, Ungari S, Zonta A, Zacchetti G, Talarico F, Pappi P, Cavalieri S, Giorgio E, Mancini C, Ferrero M, Brussino A, Savin E, Gandione M, Pelle A, Giachino DF, De Marchi M, Restagno G, Provero P, Cirillo Silengo M, Grosso E, Buxbaum JD, Pasini B, De Rubeis S, Brusco A, Ferrero GB. Copy number variants analysis in a cohort of isolated and syndromic developmental delay/intellectual disability reveals novel genomic disorders, position effects and candidate disease genes. Clin Genet 2017; 92:415-422. [PMID: 28295210 DOI: 10.1111/cge.13009] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/28/2017] [Accepted: 03/02/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Array-comparative genomic hybridization (array-CGH) is a widely used technique to detect copy number variants (CNVs) associated with developmental delay/intellectual disability (DD/ID). AIMS Identification of genomic disorders in DD/ID. MATERIALS AND METHODS We performed a comprehensive array-CGH investigation of 1,015 consecutive cases with DD/ID and combined literature mining, genetic evidence, evolutionary constraint scores, and functional information in order to assess the pathogenicity of the CNVs. RESULTS We identified non-benign CNVs in 29% of patients. Amongst the pathogenic variants (11%), detected with a yield consistent with the literature, we found rare genomic disorders and CNVs spanning known disease genes. We further identified and discussed 51 cases with likely pathogenic CNVs spanning novel candidate genes, including genes encoding synaptic components and/or proteins involved in corticogenesis. Additionally, we identified two deletions spanning potential Topological Associated Domain (TAD) boundaries probably affecting the regulatory landscape. DISCUSSION AND CONCLUSION We show how phenotypic and genetic analyses of array-CGH data allow unraveling complex cases, identifying rare disease genes, and revealing unexpected position effects.
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Affiliation(s)
- E Di Gregorio
- University of Torino, Department of Medical Sciences, Turin, Italy.,Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - E Riberi
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - E F Belligni
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - E Biamino
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - M Spielmann
- Research Group Mundlos, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - U Ala
- Computational Biology Unit, Molecular Biotechnology Center (MBC), Turin, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - A Calcia
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - I Bagnasco
- Neuropsichiatria Infantile, Martini Hospital, ASL TO1, Turin, Italy
| | - D Carli
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - G Gai
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - M Giordano
- Department of Health Sciences, Laboratory of Genetics, University of Eastern Piedmont and Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy
| | - A Guala
- SOC Pediatria, Castelli Hospital, Verbania, Italy
| | - R Keller
- Mental Health Department, ASL TO2, Adult Autism Center, Turin, Italy
| | - G Mandrile
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy.,Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy
| | - C Arduino
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - A Maffè
- Molecular Biology and Genetics Unit, Santa Croce e Carle Hospital, Cuneo, Italy
| | - V G Naretto
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - F Sirchia
- Molecular Biology and Genetics Unit, Santa Croce e Carle Hospital, Cuneo, Italy
| | - L Sorasio
- Pediatrics, Santa Croce e Carle Hospital, Cuneo, Italy
| | - S Ungari
- Molecular Biology and Genetics Unit, Santa Croce e Carle Hospital, Cuneo, Italy
| | - A Zonta
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - G Zacchetti
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy.,Department of Health Sciences, Laboratory of Genetics, University of Eastern Piedmont and Interdisciplinary Research Center of Autoimmune Diseases, Novara, Italy
| | - F Talarico
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - P Pappi
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - S Cavalieri
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - E Giorgio
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - C Mancini
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - M Ferrero
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - A Brussino
- University of Torino, Department of Medical Sciences, Turin, Italy
| | - E Savin
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - M Gandione
- Department of Neuropsychiatry, University of Torino, Turin, Italy
| | - A Pelle
- Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy.,Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - D F Giachino
- Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy.,Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - M De Marchi
- Medical Genetics, San Luigi Gonzaga University Hospital, Orbassano (TO), Italy.,Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - G Restagno
- Laboratory of Molecular Genetics, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - P Provero
- Computational Biology Unit, Molecular Biotechnology Center (MBC), Turin, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino, Turin, Italy
| | - M Cirillo Silengo
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - E Grosso
- Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - J D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - B Pasini
- Molecular Biology and Genetics Unit, Santa Croce e Carle Hospital, Cuneo, Italy
| | - S De Rubeis
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - A Brusco
- University of Torino, Department of Medical Sciences, Turin, Italy.,Medical Genetics Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
| | - G B Ferrero
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
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Tattoli F, Falconi D, De Prisco O, Maurizio G, Marazzi F, Marengo M, Serra I, Tamagnone M, Cordero di Montezemolo L, Pasini B, Formica M. [Hyperuricemia and gene mutations: a case report]. G Ital Nefrol 2017; 34:38-43. [PMID: 28700181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hyperuricemia is frequently found in nephrology. The case presented may be useful to clarify some pathogenetic aspects. It is a patient of 18 years, hyperuricaemic. Non-consanguineous parents, hyperuricemia in the paternal line, not neuropsychiatric disorders in the family. Delay in neuromotor acquisitions, average intellectual disabilities, anxiety disorder, obsessive-compulsive personality traits. Normal renal function and renal ultrasound. Evidence of hyperuricemia in 2015. Never gouty episodes and / or lithiasis, initiated allopurinol 100 mg on alternate days, with no side effects, urea in the control range, slightly below normal uricuria. Given the complex clinical, he carried out a genetic analysis of array-CGH. He showed a deletion on the short arm of chromosome 3 (3p12.3) and a duplication of the long arm of chromosome 1 (19q13-42). The deletion 3p12.3 (paternal inheritance), involves the ROBO2 gene. Duplication 19q13.42, (maternal inheritance), includes NLRP12, DPRX, ZNF331 genes. The ROBO2 gene with its mutation, is associated with vesicoureteral reflux. The NLRP12 gene encodes proteins called "Nalps", forming a subfamily of proteins "CATERPILLAR". Many "Nalps" as well as the "Nalps 12" have an N-terminal domain (DYP) with a purin. Since uric acid is a byproduct of purine metabolism, considered the familiarity, we believe that we can hypothesize that the mutations found. In particular those concerning the NLRP-12 gene, may have a role in the presence of hyperuricemia. We believe that in patients with hyperuricemia, associated with a particular impairment of neurological picture, it is likely that there is a subtended common genetic deficiency.
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Affiliation(s)
- Fabio Tattoli
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Daniela Falconi
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Ornella De Prisco
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Gherzi Maurizio
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Federico Marazzi
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Marita Marengo
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Ilaria Serra
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | - Michela Tamagnone
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
| | | | - Barbara Pasini
- S.C. Genetica Medica, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Torino
| | - Marco Formica
- S.C. Nefrologia e Dialisi ASLCN1, Ospedali di Ceva, Mondoví, Savigliano e Saluzzo
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Pignochino Y, Capozzi F, D'Ambrosio L, Dell'Aglio C, Basiricò M, Canta M, Lorenzato A, Vignolo Lutati F, Aliberti S, Palesandro E, Boccone P, Galizia D, Miano S, Chiabotto G, Napione L, Gammaitoni L, Sangiolo D, Benassi MS, Pasini B, Chiorino G, Aglietta M, Grignani G. PARP1 expression drives the synergistic antitumor activity of trabectedin and PARP1 inhibitors in sarcoma preclinical models. Mol Cancer 2017; 16:86. [PMID: 28454547 PMCID: PMC5410089 DOI: 10.1186/s12943-017-0652-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 04/17/2017] [Indexed: 01/05/2023] Open
Abstract
Background Enhancing the antitumor activity of the DNA-damaging drugs is an attractive strategy to improve current treatment options. Trabectedin is an isoquinoline alkylating agent with a peculiar mechanism of action. It binds to minor groove of DNA inducing single- and double-strand-breaks. These kinds of damage lead to the activation of PARP1, a first-line enzyme in DNA-damage response pathways. We hypothesized that PARP1 targeting could perpetuate trabectedin-induced DNA damage in tumor cells leading finally to cell death. Methods We investigated trabectedin and PARP1 inhibitor synergism in several tumor histotypes both in vitro and in vivo (subcutaneous and orthotopic tumor xenografts in mice). We searched for key determinants of drug synergism by comparative genomic hybridization (aCGH) and gene expression profiling (GEP) and validated their functional role. Results Trabectedin activated PARP1 enzyme and the combination with PARP1 inhibitors potentiated DNA damage, cell cycle arrest at G2/M checkpoint and apoptosis, if compared to single agents. Olaparib was the most active PARP1 inhibitor to combine with trabectedin and we confirmed the antitumor and antimetastatic activity of trabectedin/olaparib combination in mice models. However, we observed different degree of trabectedin/olaparib synergism among different cell lines. Namely, in DMR leiomyosarcoma models the combination was significantly more active than single agents, while in SJSA-1 osteosarcoma models no further advantage was obtained if compared to trabectedin alone. aCGH and GEP revealed that key components of DNA-repair pathways were involved in trabectedin/olaparib synergism. In particular, PARP1 expression dictated the degree of the synergism. Indeed, trabectedin/olaparib synergism was increased after PARP1 overexpression and reduced after PARP1 silencing. Conclusions PARP1 inhibition potentiated trabectedin activity in a PARP1-dependent manner and PARP1 expression in tumor cells might be a useful predictive biomarker that deserves clinical evaluation. Electronic supplementary material The online version of this article (doi:10.1186/s12943-017-0652-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ymera Pignochino
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy. .,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.
| | - Federica Capozzi
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Lorenzo D'Ambrosio
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Carmine Dell'Aglio
- Pathology Unit, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Marco Basiricò
- Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Marta Canta
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Annalisa Lorenzato
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | | | - Sandra Aliberti
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Erica Palesandro
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Paola Boccone
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Danilo Galizia
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Sara Miano
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy
| | - Giulia Chiabotto
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Lucia Napione
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.,Laboratory of Vascular Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.,Current address: Department of Applied Science and Technology, Politecnico di Torino, Torino, Italy
| | - Loretta Gammaitoni
- Laboratory of Vascular Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Dario Sangiolo
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.,Laboratory of Vascular Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Maria Serena Benassi
- Experimental Oncology Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Barbara Pasini
- Department of Genetics, Biology and Biochemistry, University of Torino, Torino, Italy
| | | | - Massimo Aglietta
- Department of Oncology, University of Torino Medical School, Candiolo, Torino, Italy.,Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy
| | - Giovanni Grignani
- Sarcoma Unit, Medical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Torino, Italy.
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Sirchia F, Di Gregorio E, Restagno G, Grosso E, Pappi P, Talarico F, Savin E, Cavalieri S, Giorgio E, Mancini C, Pasini B, Mehta JS, Brusco A. A case of Feingold type 2 syndrome associated with keratoconus refines keratoconus type 7 locus on chromosome 13q. Eur J Med Genet 2017; 60:224-227. [DOI: 10.1016/j.ejmg.2017.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/21/2016] [Accepted: 01/29/2017] [Indexed: 01/21/2023]
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Allasia M, Battaglia A, Pasini B, Gazzera C, Calandri M, Bosio A, Gontero P, Destefanis P. Treatment of multiple synchronous misdiagnosed renal cell cancers in a young patient affected by a "de novo" Von Hippel-Lindau syndrome. Urologia 2017; 84:0. [PMID: 28256701 DOI: 10.5301/uro.5000211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Von Hippel-Lindau (VHL) disease is an autosomal dominant inherited syndrome occurring in one out of 36,000 live births. Diagnosis could be a challenge in patients with no familial VHL history. Renal cancer (RCC) represents one of the most important manifestations. RCC is usually recurrent and multifocal. Actually treating RCC in VHL patients represent a clinical dilemma: the oncological outcomes must be balanced against renal function preservation. CASE PRESENTATION A young man with a negative familial history was referred to our department with seven misdiagnosed renal masses. VHL disease was determined through genetic test. The multiple RCCs were treated by surgery and percutaneous thermal ablation by radiofrequency ablation (RFA) with complete control of RCC and no impairment of renal function. CONCLUSIONS This case history confirms that VHL disease has to be suspected in young patients with evidence of synchronous multiple renal masses and in presence of specific clinical criteria.RFA appears to be safe in terms of oncological radicalism and in renal function preservation.In hereditary RCC, we should purpose, whenever it is possible, minimally invasive treatment in terms of low hospital stay and a minimal loss of renal tissue.
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Affiliation(s)
- Marco Allasia
- Division of Urology - Department of Surgical Science, A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, University of Turin, Turin - Italy
| | - Antonino Battaglia
- Division of Urology - Department of Surgical Science, A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, University of Turin, Turin - Italy
| | - Barbara Pasini
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, University of Turin, Turin - Italy
| | - Carlo Gazzera
- Department of Interventional Radiology and Diagnostic Imaging, A.O.U. Città della Salute e della Scienza - Presidio Molinette, University of Turin, Turin - Italy
| | - Marco Calandri
- Department of Interventional Radiology and Diagnostic Imaging, A.O.U. Città della Salute e della Scienza - Presidio Molinette, University of Turin, Turin - Italy
| | - Andrea Bosio
- Division of Urology - Department of Surgical Science, A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, University of Turin, Turin - Italy
| | - Paolo Gontero
- Division of Urology - Department of Surgical Science, A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, University of Turin, Turin - Italy
| | - Paolo Destefanis
- Division of Urology - Department of Surgical Science, A.O.U. Città della Salute e della Scienza di Torino - Presidio Molinette, University of Turin, Turin - Italy
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Bounous VE, Robba E, Cont NT, Sgro LG, Ferrero A, Menato G, Ponzone R, Pasini B, Biglia N. Clinico-pathological features of endometrial cancer in Lynch Syndrome patients in comparison with the general population. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pinto C, Bella MA, Capoluongo E, Carrera P, Clemente C, Colombo N, Cortesi L, De Rosa G, Fenizia F, Genuardi M, Gori S, Guarneri V, Marchetti A, Marchetti P, Normanno N, Pasini B, Pignata S, Radice P, Ricevuto E, Russo A, Tagliaferri P, Tassone P, Truini M, Varesco L. Recommendations for the implementation of BRCA testing in the care and treatment pathways of ovarian cancer patients. Future Oncol 2016; 12:2071-5. [DOI: 10.2217/fon-2016-0189] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Carmine Pinto
- Medical Oncology S.Maria Nuova Hospital – IRCCS Reggio Emilia, Italy
| | | | - Ettore Capoluongo
- Institute of Biochemistry & Clinical Biochemistry, Catholic University of the Sacred Heart, Rome, Italy
| | - Paola Carrera
- Unit of Genomics for Diagnosis of Human Pathologies, Division of Genetics & Cell Biology, & Laboratory of Clinical Molecular Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudio Clemente
- Pathology & Cytopathology Unit, Casa di Cura San Pio X & IRCCS Policlinico San Donato, Milano, Italy
| | | | - Laura Cortesi
- Department of Oncology, Hematology & Respiratory Diseases, University Hospital of Modena, Italy
| | - Gaetano De Rosa
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Francesca Fenizia
- Pharmacogenomic Laboratory, Centro di Ricerche Oncologiche di Mercogliano (CROM), Istituto Nazionale per lo Studio e la Cura dei Tumori “Fondazione Giovanni Pascale” – IRCCS Naples, Italy
| | - Maurizio Genuardi
- Institute of Genomic Medicine, ‘A Gemelli’ School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Stefania Gori
- Department of Oncology, Ospedale Sacro Cuore Don Calabria, Negrar-Verona, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology & Gastroenterology, University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Antonio Marchetti
- Center of Predictive Molecular Medicine, University-Foundation, CeSI Biotech Chieti, Italy
| | - Paolo Marchetti
- Clinical & Molecular Medicine Department, Sapienza University, Rome, Italy
| | - Nicola Normanno
- Cell Biology & Biotherapy Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori ‘Fondazione Giovanni Pascale’ – IRCCS Naples, Italy
| | - Barbara Pasini
- Department of Medical Science, University of Turin, Turin, Italy
| | - Sandro Pignata
- Uro-Gynecological Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori ‘Fondazione Giovanni Pascale’ – IRCCS Naples, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk & Genetic Testing, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Enrico Ricevuto
- Oncology Network ASL1 Abruzzo, Oncology Territorial Care Unit, Division of Medical Oncology, Department of Biotechnological & Applied Clinical Sciences, University of L'Aquila, Italy
| | - Antonio Russo
- Department of Surgical, Oncological & Oral Sciences, Section of Medical Oncology, University of Palermo, Italy
| | - Pierosandro Tagliaferri
- Department of Experimental & Clinical Medicine, Magna Graecia University, Salvatore Venuta University Campus, Catanzaro, Italy
| | - Pierfrancesco Tassone
- Sbarro Institute for Cancer Research & Molecular Medicine, Center for Biotechnology, College of Science & Technology, Temple University, Philadelphia, PA, USA
| | - Mauro Truini
- Pathological Anatomy Histology & Cytogenetics, Niguarda Cancer Center, Niguarda Ca’ Granda Hospital, Milan, Italy
| | - Liliana Varesco
- Unit of Hereditary Cancers, IRCCS AOU San Martino – IST, Genoa, Italy
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Azzollini J, Scuvera G, Bruno E, Pasanisi P, Zaffaroni D, Calvello M, Pasini B, Ripamonti CB, Colombo M, Pensotti V, Radice P, Peissel B, Manoukian S. Mutation detection rates associated with specific selection criteria for BRCA1/2 testing in 1854 high-risk families: A monocentric Italian study. Eur J Intern Med 2016; 32:65-71. [PMID: 27062684 DOI: 10.1016/j.ejim.2016.03.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND BRCA mutation screening is frequently offered on the basis of the fulfillment of empirical selection criteria, thought to be indicative of a genetic predisposition to breast/ovarian cancer (BrCa/OvCa). This study aimed to evaluate, in a large cohort of BrCa/OvCa families, the mutation detection rate (DR) associated with specific clinical features and the relative performance of the employed selection criteria. METHODS BRCA gene analysis was performed on 1854 family probands. The Fisher exact test was used to compare the DRs associated with different clinical features. In a subset of families fulfilling only mutually exclusive criteria, odds ratios and 95% CI were estimated to test the relative effectiveness of each criterion. RESULTS The overall DR was 29.3%. Among BrCa-only families, the DRs were significantly higher in the presence of early-onset compared with late-onset cases, and of bilateral compared with unilateral cases. In families with bilateral cases, ages at diagnosis of both the first and second tumour were significantly lower in mutation carriers. In families fulfilling mutually exclusive criteria, OvCa was the best predictor of BRCA mutations, with DRs (range: 31.8%-80.0%) significantly higher compared with the other criteria. Conversely, isolated early-onset BrCa and three or more late-onset BrCa displayed significantly lower predictive values (7.9% and 7.2%, respectively). CONCLUSIONS The observed estimates, albeit confirming a DR above 10% for most of the considered criteria, highlighted some relevant differences among them. Such differences should be taken into account in the identification of patients who might benefit from genetic counselling and subsequent testing.
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Affiliation(s)
- Jacopo Azzollini
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Giulietta Scuvera
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Eleonora Bruno
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Italy.
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Daniela Zaffaroni
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Mariarosaria Calvello
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Italy; Department of Predictive Medicine and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Carla B Ripamonti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Mara Colombo
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Valeria Pensotti
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy; Cogentech Cancer Genetics Test Laboratory, Milan, Italy.
| | - Paolo Radice
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Bernard Peissel
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Siranoush Manoukian
- Medical Genetics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Biglia N, Sgandurra P, Bounous VE, Maggiorotto F, Piva E, Pivetta E, Ponzone R, Pasini B. Ovarian cancer in BRCA1 and BRCA2 gene mutation carriers: analysis of prognostic factors and survival. Ecancermedicalscience 2016; 10:639. [PMID: 27350785 PMCID: PMC4898941 DOI: 10.3332/ecancer.2016.639] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Indexed: 11/30/2022] Open
Abstract
Objectives To compare clinical–pathological characteristics and outcome between sporadic ovarian cancer and ovarian cancer in patents with hereditary breast and ovarian cancer syndrome (HBOC). Methods Twenty-four patients with ovarian cancer treated between 2000 and 2009 who tested positive for BRCA1/2 mutation (BRCA+) and a control group of 64 age-matched patients with no family history of breast/ovarian cancer (controls) were enrolled. Clinical–pathological characteristics, surgical outcome, overall (OS), and progression-free survival (PFS) were compared between the two groups. Results The high-grade serous histotype was more represented in BRCA+ than in controls (70.8% versus 53.1%) (p > 0.05). BRCA+ cancers were more frequently diagnosed at stage II than controls (20.83% versus 4.69%) (p = 0.024). Radical primary surgery was performed in 70% of women in both groups, with no difference in debulking results. In patients undergoing surgery after neoadjuvant chemotherapy, in all BRCA+ patients, optimal cytoreduction was achieved (versus 70% of the controls). PFS was significantly longer for BRCA+ patients compared to controls (60 months versus 22 months; p = 0.039). No significant difference was observed in OS between BRCA+ patients and controls. Conclusions At a median follow-up time of 46 months, BRCA+ patients have a better prognosis than controls in terms of PFS. Higher chemosensitivity of BRCA+ tumours was observed.
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Affiliation(s)
- Nicoletta Biglia
- Unit of Obstetrics and Gynaecology, Mauriziano Umberto I Hospital, Largo Turati, 62, 10128, Turin, Italy
| | - Paola Sgandurra
- Gynecological Oncology Unit, Candiolo Cancer Institute FPO, IRCCS, Km 3,95, SP142, 10060 Candiolo (TO), Italy
| | | | - Furio Maggiorotto
- Gynecological Oncology Unit, Candiolo Cancer Institute FPO, IRCCS, Km 3,95, SP142, 10060 Candiolo (TO), Italy
| | - Eleonora Piva
- Obstetrics and Gynaecology I, Sant'Anna Hospital, AOU Città della Salute e della Scienza di Torino, Corso Spezia, 60, 10126, Turin, Italy
| | - Emanuele Pivetta
- AOU Città della Salute e della Scienza, Department of Medical Sciences, Corso Bramante, 88-10126, Turin, Italy
| | - Riccardo Ponzone
- Gynecological Oncology Unit, Candiolo Cancer Institute FPO, IRCCS, Km 3,95, SP142, 10060 Candiolo (TO), Italy
| | - Barbara Pasini
- AOU Città della Salute e della Scienza, SC Genetica Medica U, Via Santena, 19-10126, Turin, Italy
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Silvestri V, Barrowdale D, Mulligan AM, Neuhausen SL, Fox S, Karlan BY, Mitchell G, James P, Thull DL, Zorn KK, Carter NJ, Nathanson KL, Domchek SM, Rebbeck TR, Ramus SJ, Nussbaum RL, Olopade OI, Rantala J, Yoon SY, Caligo MA, Spugnesi L, Bojesen A, Pedersen IS, Thomassen M, Jensen UB, Toland AE, Senter L, Andrulis IL, Glendon G, Hulick PJ, Imyanitov EN, Greene MH, Mai PL, Singer CF, Rappaport-Fuerhauser C, Kramer G, Vijai J, Offit K, Robson M, Lincoln A, Jacobs L, Machackova E, Foretova L, Navratilova M, Vasickova P, Couch FJ, Hallberg E, Ruddy KJ, Sharma P, Kim SW, Teixeira MR, Pinto P, Montagna M, Matricardi L, Arason A, Johannsson OT, Barkardottir RB, Jakubowska A, Lubinski J, Izquierdo A, Pujana MA, Balmaña J, Diez O, Ivady G, Papp J, Olah E, Kwong A, Nevanlinna H, Aittomäki K, Perez Segura P, Caldes T, Van Maerken T, Poppe B, Claes KBM, Isaacs C, Elan C, Lasset C, Stoppa-Lyonnet D, Barjhoux L, Belotti M, Meindl A, Gehrig A, Sutter C, Engel C, Niederacher D, Steinemann D, Hahnen E, Kast K, Arnold N, Varon-Mateeva R, Wand D, Godwin AK, Evans DG, Frost D, Perkins J, Adlard J, Izatt L, Platte R, Eeles R, Ellis S, Hamann U, Garber J, Fostira F, Fountzilas G, Pasini B, Giannini G, Rizzolo P, Russo A, Cortesi L, Papi L, Varesco L, Palli D, Zanna I, Savarese A, Radice P, Manoukian S, Peissel B, Barile M, Bonanni B, Viel A, Pensotti V, Tommasi S, Peterlongo P, Weitzel JN, Osorio A, Benitez J, McGuffog L, Healey S, Gerdes AM, Ejlertsen B, Hansen TVO, Steele L, Ding YC, Tung N, Janavicius R, Goldgar DE, Buys SS, Daly MB, Bane A, Terry MB, John EM, Southey M, Easton DF, Chenevix-Trench G, Antoniou AC, Ottini L. Male breast cancer in BRCA1 and BRCA2 mutation carriers: pathology data from the Consortium of Investigators of Modifiers of BRCA1/2. Breast Cancer Res 2016; 18:15. [PMID: 26857456 PMCID: PMC4746828 DOI: 10.1186/s13058-016-0671-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 01/06/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND BRCA1 and, more commonly, BRCA2 mutations are associated with increased risk of male breast cancer (MBC). However, only a paucity of data exists on the pathology of breast cancers (BCs) in men with BRCA1/2 mutations. Using the largest available dataset, we determined whether MBCs arising in BRCA1/2 mutation carriers display specific pathologic features and whether these features differ from those of BRCA1/2 female BCs (FBCs). METHODS We characterised the pathologic features of 419 BRCA1/2 MBCs and, using logistic regression analysis, contrasted those with data from 9675 BRCA1/2 FBCs and with population-based data from 6351 MBCs in the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS Among BRCA2 MBCs, grade significantly decreased with increasing age at diagnosis (P = 0.005). Compared with BRCA2 FBCs, BRCA2 MBCs were of significantly higher stage (P for trend = 2 × 10(-5)) and higher grade (P for trend = 0.005) and were more likely to be oestrogen receptor-positive [odds ratio (OR) 10.59; 95 % confidence interval (CI) 5.15-21.80] and progesterone receptor-positive (OR 5.04; 95 % CI 3.17-8.04). With the exception of grade, similar patterns of associations emerged when we compared BRCA1 MBCs and FBCs. BRCA2 MBCs also presented with higher grade than MBCs from the SEER database (P for trend = 4 × 10(-12)). CONCLUSIONS On the basis of the largest series analysed to date, our results show that BRCA1/2 MBCs display distinct pathologic characteristics compared with BRCA1/2 FBCs, and we identified a specific BRCA2-associated MBC phenotype characterised by a variable suggesting greater biological aggressiveness (i.e., high histologic grade). These findings could lead to the development of gender-specific risk prediction models and guide clinical strategies appropriate for MBC management.
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Affiliation(s)
- Valentina Silvestri
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
| | - Daniel Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Anna Marie Mulligan
- Laboratory Medicine Program, University Health Network, Toronto, ON, Canada.
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA.
| | - Stephen Fox
- Peter MacCallum Cancer Institute, East Melbourne, Australia.
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Gillian Mitchell
- Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Australia.
- Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
| | - Paul James
- Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Australia.
- Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
| | - Darcy L Thull
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Kristin K Zorn
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | | | - Katherine L Nathanson
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA.
| | - Susan M Domchek
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA.
| | - Timothy R Rebbeck
- Department of Epidemiology and Biostatistics, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Susan J Ramus
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
| | - Robert L Nussbaum
- Department of Medicine and Genetics, University of California, San Francisco, San Francisco, CA, USA.
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health, University of Chicago Medical Center, Chicago, IL, USA.
| | - Johanna Rantala
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden.
| | - Sook-Yee Yoon
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia.
- University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia.
| | - Maria A Caligo
- Section of Genetic Oncology, Department of Laboratory Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy.
| | - Laura Spugnesi
- Section of Genetic Oncology, Department of Laboratory Medicine, University of Pisa and University Hospital of Pisa, Pisa, Italy.
| | - Anders Bojesen
- Department of Clinical Genetics, Vejle Hospital, Vejle, Denmark.
| | - Inge Sokilde Pedersen
- Section of Molecular Diagnostics, Department of Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odense C, Denmark.
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus N, Denmark.
| | - Amanda Ewart Toland
- Department of Molecular Virology, Immunology and Medical Genetics, College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Leigha Senter
- Division of Human Genetics, Department of Internal Medicine, The Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| | - Irene L Andrulis
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.
| | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
| | - Peter J Hulick
- Center for Medical Genetics, North Shore University Health System, Evanston, IL, USA.
| | | | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
| | - Phuong L Mai
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
| | - Christian F Singer
- Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
| | | | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria.
| | - Joseph Vijai
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
| | - Kenneth Offit
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
| | - Mark Robson
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
| | - Anne Lincoln
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
| | - Lauren Jacobs
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
| | - Eva Machackova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
| | - Lenka Foretova
- Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Marie Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
| | - Petra Vasickova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Emily Hallberg
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | | | - Priyanka Sharma
- Department of Hematology and Oncology, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Sung-Won Kim
- Department of Surgery, Daerim St. Mary's Hospital, Seoul, Korea.
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Institute of Oncology, Porto, Portugal.
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal.
| | - Pedro Pinto
- Department of Genetics, Portuguese Institute of Oncology, Porto, Portugal.
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS (Scientific Institute of Hospitalization and Care), Padua, Italy.
| | - Laura Matricardi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS (Scientific Institute of Hospitalization and Care), Padua, Italy.
| | - Adalgeir Arason
- Department of Pathology, Landspitali University Hospital and Biomedical Centre (BMC), Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Oskar Th Johannsson
- Department of Oncology, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Rosa B Barkardottir
- Department of Pathology, Landspitali University Hospital and Biomedical Centre (BMC), Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
| | - Angel Izquierdo
- Genetic Counseling Unit, Hereditary Cancer Program, Biomedical Research Institute of Girona (IDIBGI), Catalan Institute of Oncology, Girona, Spain.
| | - Miguel Angel Pujana
- Breast Cancer and Systems Biology Unit, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Barcelona, Spain.
| | - Judith Balmaña
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain.
| | - Orland Diez
- Oncogenetics Group, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Gabriella Ivady
- Department of Pathology, National Institute of Oncology, Budapest, Hungary.
| | - Janos Papp
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.
| | - Edith Olah
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.
| | - Ava Kwong
- The Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Hong Kong, China.
- Department of Surgery, The University of Hong Kong, Hong Kong, China.
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Kristiina Aittomäki
- Department of Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Pedro Perez Segura
- Department of Oncology, San Carlos Clinical Hospital Health Research Institute (IdISSC), San Carlos Clinical Hospital, Madrid, Spain.
| | - Trinidad Caldes
- Molecular Oncology Laboratory, San Carlos Clinical Hospital Health Research Institute (IdISSC), San Carlos Clinical Hospital, Madrid, Spain.
| | - Tom Van Maerken
- Center for Medical Genetics, Ghent University, Ghent, Belgium.
| | - Bruce Poppe
- Center for Medical Genetics, Ghent University, Ghent, Belgium.
| | | | - Claudine Isaacs
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
| | - Camille Elan
- Department of Tumour Biology, Institut Curie, Paris, France.
| | - Christine Lasset
- CNRS UMR5558, Université Lyon 1, Lyon, France.
- Unité de Prévention et d'Epidémiologie Génétique, Centre Léon Bérard, Lyon, France.
| | - Dominique Stoppa-Lyonnet
- Department of Tumour Biology, Institut Curie, Paris, France.
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Laure Barjhoux
- INSERM U1052, CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, Université Lyon, Lyon, France.
| | - Muriel Belotti
- Department of Tumour Biology, Institut Curie, Paris, France.
| | - Alfons Meindl
- Department of Gynaecology and Obstetrics, Technical University of Munich, Munich, Germany.
| | - Andrea Gehrig
- Institute of Human Genetics, University of Wurzburg, Wurzburg, Germany.
| | - Christian Sutter
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany.
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology University of Leipzig, Leipzig, Germany.
| | | | | | - Eric Hahnen
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany.
| | - Karin Kast
- Department of Gynecology and Obstetrics, Technical University of Dresden, Dresden, Germany.
| | - Norbert Arnold
- Department of Gynaecolgy and Obstetrics, University Hospital of Schleswig-Holstein, Christian-Albrechts-University of Kiel, Kiel, Germany.
| | | | | | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - D Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Jo Perkins
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | | | - Louise Izatt
- Clinical Genetics, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
| | - Radka Platte
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK.
| | - Ros Eeles
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Steve Ellis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Judy Garber
- Cancer Risk and Prevention Clinic, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, Institute of Nuclear and Radiological Sciences and Technology (INRASTES), National Centre for Scientific Research "Demokritos", Aghia Paraskevi Attikis, Athens, Greece.
| | - George Fountzilas
- Department of Medical Oncology, Papageorgiou Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece.
| | - Barbara Pasini
- Department of Medical Science, University of Turin, Turin, Italy.
- AO Città della Salute e della Scienza, Turin, Italy.
| | - Giuseppe Giannini
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
| | - Piera Rizzolo
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
| | - Antonio Russo
- Section of Medical Oncology, Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy.
| | - Laura Cortesi
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy.
| | - Laura Papi
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy.
| | - Liliana Varesco
- Unit of Hereditary Cancer, Department of Epidemiology, Prevention and Special Functions, IRCCS (Scientific Institute of Hospitalization and Care), AOU San Martino - IST National Institute for Cancer Research, Genoa, Italy.
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
| | - Ines Zanna
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
| | - Antonella Savarese
- Unit of Genetic Counselling, Medical Oncology Department, Regina Elena National Cancer Institute, Rome, Italy.
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, IRCCS (Scientific Institute of Hospitalization and Care), National Cancer Institute (INT), 20133, Milan, Italy.
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, IRCCS (Scientific Institute of Hospitalization and Care), National Cancer Institute (INT), Milan, Italy.
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, IRCCS (Scientific Institute of Hospitalization and Care), National Cancer Institute (INT), Milan, Italy.
| | - Monica Barile
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), Milan, Italy.
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, European Institute of Oncology (IEO), Milan, Italy.
| | - Alessandra Viel
- Division of Experimental Oncology, CRO Aviano National Cancer Institute, Aviano, PN, Italy.
| | - Valeria Pensotti
- IFOM, FIRC (Italian Foundation for Cancer Research) Institute of Molecular Oncology, Milan, Italy.
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy.
| | | | - Paolo Peterlongo
- IFOM, FIRC (Italian Foundation for Cancer Research) Institute of Molecular Oncology, Milan, Italy.
| | - Jeffrey N Weitzel
- Clinical Cancer Genetics, City of Hope Clinical Cancer Genetics Community Research Network, Duarte, CA, USA.
| | - Ana Osorio
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Centre (CNIO), Madrid, Spain.
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain.
| | - Javier Benitez
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain.
- Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain.
- Human Genotyping (CEGEN) Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Sue Healey
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Bent Ejlertsen
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Thomas V O Hansen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA.
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA.
| | - Nadine Tung
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Ramunas Janavicius
- State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.
| | - David E Goldgar
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Saundra S Buys
- Department of Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA.
| | - Anita Bane
- Department of Pathology & Molecular Medicine, Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada.
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Esther M John
- Department of Epidemiology, Cancer Prevention Institute of California, Fremont, CA, USA.
| | - Melissa Southey
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Parkville, Australia.
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | | | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Laura Ottini
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
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Di Gregorio E, Gai G, Botta G, Calcia A, Pappi P, Talarico F, Savin E, Ribotta M, Zonta A, Mancini C, Giorgio E, Cavalieri S, Restagno G, Ferrero GB, Viora E, Pasini B, Grosso E, Brusco A, Brussino A. Array-Comparative Genomic Hybridization Analysis in Fetuses with Major Congenital Malformations Reveals that 24% of Cases Have Pathogenic Deletions/Duplications. Cytogenet Genome Res 2015; 147:10-6. [PMID: 26658296 DOI: 10.1159/000442308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 11/19/2022] Open
Abstract
Karyotyping and aCGH are routinely used to identify genetic determinants of major congenital malformations (MCMs) in fetal deaths or terminations of pregnancy after prenatal diagnosis. Pathogenic rearrangements are found with a variable rate of 9-39% for aCGH. We collected 33 fetuses, 9 with a single MCM and 24 with MCMs involving 2-4 organ systems. aCGH revealed copy number variants in 14 out of 33 cases (42%). Eight were classified as pathogenic which account for a detection rate of 24% (8/33) considering fetuses with 1 or more MCMs and 33% (8/24) taking into account fetuses with multiple malformations only. Three of the pathogenic variants were known microdeletion syndromes (22q11.21 deletion, central chromosome 22q11.21 deletion, and TAR syndrome) and 5 were large rearrangements, adding up to >11 Mb per subject and comprising strong phenotype-related genes. One of those was a de novo complex rearrangement, and the remaining 4 duplications and 2 deletions were 130-900 kb in size, containing 1-7 genes, and were classified as variants of unknown clinical significance. Our study confirms aCGH as a powerful technique to ascertain the genetic etiology of fetal major congenital malformations.
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Gironi LC, Colombo E, Farinelli P, Giorgione R, Bozzola C, Ogliara P, Pasini B. Germline CDKN2A mutations in childhood melanoma: a case of melanoma-pancreatic cancer syndrome. Int J Dermatol 2015; 54:e553-5. [PMID: 26381259 DOI: 10.1111/ijd.12933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 11/22/2014] [Accepted: 12/03/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Laura Cristina Gironi
- Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy.
| | - Enrico Colombo
- Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy
| | - Pamela Farinelli
- Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy
| | - Roberto Giorgione
- Dermatology Clinic, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy
| | - Cristina Bozzola
- Pathology Unit, Department of Health Sciences, University of Piemonte Orientale, Amedeo Avogadro, Novara, Italy
| | - Paola Ogliara
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
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48
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Rebbeck TR, Mitra N, Wan F, Sinilnikova OM, Healey S, McGuffog L, Mazoyer S, Chenevix-Trench G, Easton DF, Antoniou AC, Nathanson KL, Laitman Y, Kushnir A, Paluch-Shimon S, Berger R, Zidan J, Friedman E, Ehrencrona H, Stenmark-Askmalm M, Einbeigi Z, Loman N, Harbst K, Rantala J, Melin B, Huo D, Olopade OI, Seldon J, Ganz PA, Nussbaum RL, Chan SB, Odunsi K, Gayther SA, Domchek SM, Arun BK, Lu KH, Mitchell G, Karlan BY, Walsh C, Lester J, Godwin AK, Pathak H, Ross E, Daly MB, Whittemore AS, John EM, Miron A, Terry MB, Chung WK, Goldgar DE, Buys SS, Janavicius R, Tihomirova L, Tung N, Dorfling CM, van Rensburg EJ, Steele L, Neuhausen SL, Ding YC, Ejlertsen B, Gerdes AM, Hansen TVO, Ramón y Cajal T, Osorio A, Benitez J, Godino J, Tejada MI, Duran M, Weitzel JN, Bobolis KA, Sand SR, Fontaine A, Savarese A, Pasini B, Peissel B, Bonanni B, Zaffaroni D, Vignolo-Lutati F, Scuvera G, Giannini G, Bernard L, Genuardi M, Radice P, Dolcetti R, Manoukian S, Pensotti V, Gismondi V, Yannoukakos D, Fostira F, Garber J, Torres D, Rashid MU, Hamann U, Peock S, Frost D, Platte R, Evans DG, Eeles R, Davidson R, Eccles D, Cole T, Cook J, Brewer C, Hodgson S, Morrison PJ, Walker L, Porteous ME, Kennedy MJ, Izatt L, Adlard J, Donaldson A, Ellis S, Sharma P, Schmutzler RK, Wappenschmidt B, Becker A, Rhiem K, Hahnen E, Engel C, Meindl A, Engert S, Ditsch N, Arnold N, Plendl HJ, Mundhenke C, Niederacher D, Fleisch M, Sutter C, Bartram CR, Dikow N, Wang-Gohrke S, Gadzicki D, Steinemann D, Kast K, Beer M, Varon-Mateeva R, Gehrig A, Weber BH, Stoppa-Lyonnet D, Sinilnikova OM, Mazoyer S, Houdayer C, Belotti M, Gauthier-Villars M, Damiola F, Boutry-Kryza N, Lasset C, Sobol H, Peyrat JP, Muller D, Fricker JP, Collonge-Rame MA, Mortemousque I, Nogues C, Rouleau E, Isaacs C, De Paepe A, Poppe B, Claes K, De Leeneer K, Piedmonte M, Rodriguez G, Wakely K, Boggess J, Blank SV, Basil J, Azodi M, Phillips KA, Caldes T, de la Hoya M, Romero A, Nevanlinna H, Aittomäki K, van der Hout AH, Hogervorst FBL, Verhoef S, Collée JM, Seynaeve C, Oosterwijk JC, Gille JJP, Wijnen JT, Gómez Garcia EB, Kets CM, Ausems MGEM, Aalfs CM, Devilee P, Mensenkamp AR, Kwong A, Olah E, Papp J, Diez O, Lazaro C, Darder E, Blanco I, Salinas M, Jakubowska A, Lubinski J, Gronwald J, Jaworska-Bieniek K, Durda K, Sukiennicki G, Huzarski T, Byrski T, Cybulski C, Toloczko-Grabarek A, Złowocka-Perłowska E, Menkiszak J, Arason A, Barkardottir RB, Simard J, Laframboise R, Montagna M, Agata S, Alducci E, Peixoto A, Teixeira MR, Spurdle AB, Lee MH, Park SK, Kim SW, Friebel TM, Couch FJ, Lindor NM, Pankratz VS, Guidugli L, Wang X, Tischkowitz M, Foretova L, Vijai J, Offit K, Robson M, Rau-Murthy R, Kauff N, Fink-Retter A, Singer CF, Rappaport C, Gschwantler-Kaulich D, Pfeiler G, Tea MK, Berger A, Greene MH, Mai PL, Imyanitov EN, Toland AE, Senter L, Bojesen A, Pedersen IS, Skytte AB, Sunde L, Thomassen M, Moeller ST, Kruse TA, Jensen UB, Caligo MA, Aretini P, Teo SH, Selkirk CG, Hulick PJ, Andrulis I. Association of type and location of BRCA1 and BRCA2 mutations with risk of breast and ovarian cancer. JAMA 2015; 313:1347-61. [PMID: 25849179 PMCID: PMC4537700 DOI: 10.1001/jama.2014.5985] [Citation(s) in RCA: 347] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Limited information about the relationship between specific mutations in BRCA1 or BRCA2 (BRCA1/2) and cancer risk exists. OBJECTIVE To identify mutation-specific cancer risks for carriers of BRCA1/2. DESIGN, SETTING, AND PARTICIPANTS Observational study of women who were ascertained between 1937 and 2011 (median, 1999) and found to carry disease-associated BRCA1 or BRCA2 mutations. The international sample comprised 19,581 carriers of BRCA1 mutations and 11,900 carriers of BRCA2 mutations from 55 centers in 33 countries on 6 continents. We estimated hazard ratios for breast and ovarian cancer based on mutation type, function, and nucleotide position. We also estimated RHR, the ratio of breast vs ovarian cancer hazard ratios. A value of RHR greater than 1 indicated elevated breast cancer risk; a value of RHR less than 1 indicated elevated ovarian cancer risk. EXPOSURES Mutations of BRCA1 or BRCA2. MAIN OUTCOMES AND MEASURES Breast and ovarian cancer risks. RESULTS Among BRCA1 mutation carriers, 9052 women (46%) were diagnosed with breast cancer, 2317 (12%) with ovarian cancer, 1041 (5%) with breast and ovarian cancer, and 7171 (37%) without cancer. Among BRCA2 mutation carriers, 6180 women (52%) were diagnosed with breast cancer, 682 (6%) with ovarian cancer, 272 (2%) with breast and ovarian cancer, and 4766 (40%) without cancer. In BRCA1, we identified 3 breast cancer cluster regions (BCCRs) located at c.179 to c.505 (BCCR1; RHR = 1.46; 95% CI, 1.22-1.74; P = 2 × 10(-6)), c.4328 to c.4945 (BCCR2; RHR = 1.34; 95% CI, 1.01-1.78; P = .04), and c. 5261 to c.5563 (BCCR2', RHR = 1.38; 95% CI, 1.22-1.55; P = 6 × 10(-9)). We also identified an ovarian cancer cluster region (OCCR) from c.1380 to c.4062 (approximately exon 11) with RHR = 0.62 (95% CI, 0.56-0.70; P = 9 × 10(-17)). In BRCA2, we observed multiple BCCRs spanning c.1 to c.596 (BCCR1; RHR = 1.71; 95% CI, 1.06-2.78; P = .03), c.772 to c.1806 (BCCR1'; RHR = 1.63; 95% CI, 1.10-2.40; P = .01), and c.7394 to c.8904 (BCCR2; RHR = 2.31; 95% CI, 1.69-3.16; P = .00002). We also identified 3 OCCRs: the first (OCCR1) spanned c.3249 to c.5681 that was adjacent to c.5946delT (6174delT; RHR = 0.51; 95% CI, 0.44-0.60; P = 6 × 10(-17)). The second OCCR spanned c.6645 to c.7471 (OCCR2; RHR = 0.57; 95% CI, 0.41-0.80; P = .001). Mutations conferring nonsense-mediated decay were associated with differential breast or ovarian cancer risks and an earlier age of breast cancer diagnosis for both BRCA1 and BRCA2 mutation carriers. CONCLUSIONS AND RELEVANCE Breast and ovarian cancer risks varied by type and location of BRCA1/2 mutations. With appropriate validation, these data may have implications for risk assessment and cancer prevention decision making for carriers of BRCA1 and BRCA2 mutations.
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Affiliation(s)
- Timothy R Rebbeck
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia2Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Nandita Mitra
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Fei Wan
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Olga M Sinilnikova
- Centre de Recherche en Cancérologie de Lyon, UMR Inserm, Centre Léon Bérard, Lyon, France
| | - Sue Healey
- Department of Genetics and Computational Biology, Queensland Institute of Medical Research, Brisbane, Australia
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Sylvie Mazoyer
- Centre de Recherche en Cancérologie de Lyon, UMR Inserm, Centre Léon Bérard, Lyon, France
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, Queensland Institute of Medical Research, Brisbane, Australia
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Katherine L Nathanson
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia6Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | - Anya Kushnir
- Susanne Levy Gertner Oncogenetics Unit, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Raanan Berger
- Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Jamal Zidan
- Oncology Institute, Rivkah Ziv Medical Center Zefat, Israel
| | | | - Hans Ehrencrona
- Department of Oncology, Lund University, Lund, Sweden12Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Marie Stenmark-Askmalm
- Division of Clinical Genetics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Zakaria Einbeigi
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Niklas Loman
- Department of Oncology, Lund University, Lund, Sweden
| | - Katja Harbst
- Department of Oncology, Lund University, Lund, Sweden
| | - Johanna Rantala
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Beatrice Melin
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Dezheng Huo
- Center for Clinical Cancer Genetics and Global Health, University of Chicago Medical Center, Chicago, Illinois
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health, University of Chicago Medical Center, Chicago, Illinois
| | - Joyce Seldon
- UCLA Schools of Medicine and Public Health, Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Patricia A Ganz
- UCLA Schools of Medicine and Public Health, Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - Robert L Nussbaum
- Department of Medicine and Genetics, University of California, San Francisco
| | - Salina B Chan
- Cancer Risk Program, Helen Diller Family Cancer Center, University of California, San Francisco
| | - Kunle Odunsi
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, New York
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Susan M Domchek
- Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia6Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Banu K Arun
- University of Texas MD Anderson Cancer Center, Houston
| | - Karen H Lu
- University of Texas MD Anderson Cancer Center, Houston
| | - Gillian Mitchell
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia 25Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Christine Walsh
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City
| | - Harsh Pathak
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City
| | - Eric Ross
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Mary B Daly
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Alice S Whittemore
- Cancer Risk Program, Helen Diller Family Cancer Center, University of California, San Francisco
| | - Esther M John
- Department of Epidemiology, Cancer Prevention Institute of California, Fremont
| | | | - Mary Beth Terry
- Department of Epidemiology, Columbia University, New York, New York
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, New York
| | - David E Goldgar
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City
| | - Saundra S Buys
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City
| | - Ramunas Janavicius
- Vilnius University Hospital Santariskiu Clinics, Hematology, Oncology, and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, State Research Institute Innovative Medicine Center, Vilnius, Lithuania
| | | | - Nadine Tung
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | | | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Bent Ejlertsen
- Departments of Oncology or Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne-Marie Gerdes
- Departments of Oncology or Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas v O Hansen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Centre (CNIO), and Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Javier Benitez
- Human Genetics Group and Genotyping Unit, Spanish National Cancer Centre (CNIO), and Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Javier Godino
- Hospital clinico Universitario "Lozano Blesa," Instituto de investigación sanitaria de Aragón (IIS), Zaragoza, Spain
| | - Maria-Isabel Tejada
- Molecular Genetics Laboratory (Department of Genetics), Cruces University Hospital Barakaldo, Bizkaia, Spain
| | - Mercedes Duran
- Institute of Biology and Molecular Genetics. Universidad de Valladolid (IBGM-UVA), Valladolid, Spain
| | - Jeffrey N Weitzel
- Clinical Cancer Genetics, City of Hope Clinical Cancer Genetics Community Research Network, Duarte, California
| | - Kristie A Bobolis
- Clinical Cancer Genetics, City of Hope Clinical Cancer Genetics Community Research Network, Duarte, California
| | - Sharon R Sand
- Clinical Cancer Genetics, City of Hope Clinical Cancer Genetics Community Research Network, Duarte, California
| | - Annette Fontaine
- Clinical Cancer Genetics, City of Hope Clinical Cancer Genetics Community Research Network, Duarte, California
| | - Antonella Savarese
- Unit of Genetic Counselling, Medical Oncology Department, Istituto Nazionale Tumori Regina Elena, Rome, Italy
| | - Barbara Pasini
- Department of Medical Science, University of Turin, and AO Città della Salute e della Scienza, Turin, Italy
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia, Milan, Italy
| | - Daniela Zaffaroni
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | | | - Giulietta Scuvera
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Loris Bernard
- Department of Experimental Oncology, Istituto Europeo di Oncologia, Milan, Italy57Cogentech Cancer Genetic Test Laboratory, Milan, Italy
| | - Maurizio Genuardi
- Institute of Medical Genetics, Catholic University, "A. Gemelli" Hospital, Rome, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori (INT), Milan, Italy60IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - Riccardo Dolcetti
- Cancer Bioimmunotherapy Unit, Centro di Riferimento Oncologico, IRCCSCRO Aviano National Cancer Institute, Aviano (PN), Italy
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Valeria Pensotti
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy60IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - Viviana Gismondi
- Unit of Hereditary Cancer, IRCCS AOU San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research "Demokritos" Aghia Paraskevi Attikis, Athens, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research "Demokritos" Aghia Paraskevi Attikis, Athens, Greece
| | - Judy Garber
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Diana Torres
- Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia65Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Muhammad Usman Rashid
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany 66Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Susan Peock
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Radka Platte
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - D Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals, NHS Foundation Trust, Manchester, United Kingdom
| | - Rosalind Eeles
- Oncogenetics Team, Institute of Cancer Research and Royal Marsden, NHS Foundation Trust, London, United Kingdom
| | - Rosemarie Davidson
- Ferguson-Smith Centre for Clinical Genetics, Yorkhill Hospitals, Glasgow, United Kingdom
| | - Diana Eccles
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Trevor Cole
- West Midlands Regional Genetics Service, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham, United Kingdom
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, United Kingdom
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Shirley Hodgson
- Clinical Genetics Department, St Georges Hospital, University of London, United Kingdom
| | - Patrick J Morrison
- Northern Ireland Regional Genetics Centre, Belfast City Hospital, Belfast, United Kingdom
| | - Lisa Walker
- Oxford Regional Genetics Service, Churchill Hospital, Oxford, United Kingdom
| | - Mary E Porteous
- South East of Scotland Regional Genetics Service, Western General Hospital, Edinburgh, United Kingdom
| | - M John Kennedy
- Academic Unit of Clinical and Molecular Oncology, Trinity College Dublin and St James's Hospital, Dublin, Eire
| | - Louise Izatt
- South East Thames Regional Genetics Service, Guy's Hospital London, United Kingdom
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Leeds, United Kingdom
| | - Alan Donaldson
- South West Regional Genetics Service, Bristol, United Kingdom
| | - Steve Ellis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Priyanka Sharma
- Department of Hematology and Oncology, University of Kansas Medical Center, Kansas City
| | - Rita Katharina Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Barbara Wappenschmidt
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Alexandra Becker
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Eric Hahnen
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Alfons Meindl
- Department of Gynaecology and Obstetrics, Division of Tumor Genetics, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Stefanie Engert
- Department of Gynaecology and Obstetrics, Division of Tumor Genetics, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Nina Ditsch
- Department of Gynaecology and Obstetrics, Division of Tumor Genetics, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Norbert Arnold
- Department of Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Hans Jörg Plendl
- Institute of Human Genetics, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Christoph Mundhenke
- Department of Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Dieter Niederacher
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Markus Fleisch
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Sutter
- Institute of Human Genetics, Department of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - C R Bartram
- Institute of Human Genetics, Department of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicola Dikow
- Institute of Human Genetics, Department of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Shan Wang-Gohrke
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Dorothea Gadzicki
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | - Doris Steinemann
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | - Karin Kast
- Department of Gynaecology and Obstetrics, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Marit Beer
- Institute of Human Genetics, Technical University Dresden, Dresden, Germany
| | | | - Andrea Gehrig
- Centre of Familial Breast and Ovarian Cancer, Department of Medical Genetics, Institute of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Bernhard H Weber
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Department of Tumour Biology, Paris, France98Institut Curie, INSERM U830, Paris, France99Université Paris Descartes, Sorbonne Paris Cité, France
| | - Olga M Sinilnikova
- Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon-Centre Léon Bérard, Lyon, France101INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Sylvie Mazoyer
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Claude Houdayer
- Institut Curie, Department of Tumour Biology, Paris, France99Université Paris Descartes, Sorbonne Paris Cité, France
| | - Muriel Belotti
- Institut Curie, Department of Tumour Biology, Paris, France
| | | | - Francesca Damiola
- INSERM U1052, CNRS UMR5286, Université Lyon 1, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Nadia Boutry-Kryza
- Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon-Centre Léon Bérard, Lyon, France
| | - Christine Lasset
- Université Lyon 1, CNRS UMR5558, Lyon, France103Unité de Prévention et d'Epidémiologie Génétique, Centre Léon Bérard, Lyon, France
| | - Hagay Sobol
- Département Oncologie Génétique, Prévention et Dépistage, INSERM CIC-P9502, Institut Paoli-Calmettes/Université d'Aix-Marseille II, Marseille, France
| | - Jean-Philippe Peyrat
- Laboratoire d'Oncologie Moléculaire Humaine, Centre Oscar Lambret, Lille, France
| | - Danièle Muller
- Unité d'Oncogénétique, CLCC Paul Strauss, Strasbourg, France
| | | | - Marie-Agnès Collonge-Rame
- Service de Génétique Biologique-Histologie-Biologie du Développement et de la Reproduction, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | | | - Catherine Nogues
- Oncogénétique Clinique, Hôpital René Huguenin/Institut Curie, Saint-Cloud, France
| | - Etienne Rouleau
- Laboratoire d'Oncogénétique, Hôpital René Huguenin/Institut Curie, Saint-Cloud, France
| | - Claudine Isaacs
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Anne De Paepe
- Center for Medical Genetics, Ghent University, Ghent, Belgium
| | - Bruce Poppe
- Center for Medical Genetics, Ghent University, Ghent, Belgium
| | - Kathleen Claes
- Center for Medical Genetics, Ghent University, Ghent, Belgium
| | - Kim De Leeneer
- Center for Medical Genetics, Ghent University, Ghent, Belgium
| | | | | | | | | | | | - Jack Basil
- Ohio State, Good Samaritan Hospital, Cincinnati
| | - Masoud Azodi
- Yale University School of Medicine, New Haven, Connecticut
| | - Kelly-Anne Phillips
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia 25Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Trinidad Caldes
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Miguel de la Hoya
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Atocha Romero
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
| | - Annemarie H van der Hout
- Department of Genetics, University Medical Center, Groningen University, Groningen, The Netherlands
| | | | - Senno Verhoef
- Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J Margriet Collée
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Caroline Seynaeve
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan C Oosterwijk
- Department of Genetics, University Medical Center, Groningen University, Groningen, The Netherlands
| | - Johannes J P Gille
- Department of Clinical Genetics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Juul T Wijnen
- Department of Human Genetics and Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Encarna B Gómez Garcia
- Department of Clinical Genetics and GROW, School for Oncology and Developmental Biology, MUMC, Maastricht, The Netherlands
| | - Carolien M Kets
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Margreet G E M Ausems
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cora M Aalfs
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands
| | - Peter Devilee
- Department of Human Genetics and Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arjen R Mensenkamp
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Ava Kwong
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong135Cancer Genetics Center, Hong Kong Sanatorium and Hospital, Hong Kong136Department of Surgery, University of Hong Kong, Hong Kong
| | - Edith Olah
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | - Janos Papp
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | - Orland Diez
- Oncogenetics Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autonoma de Barcelona, Barcelona, Spain139University Hospital of Vall d'Hebron, Barcelona, Spain
| | - Conxi Lazaro
- Molecular Diagnostic Unit, Hereditary Cancer Program, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain
| | - Esther Darder
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBGI-Catalan Institute of Oncology, Girona, Spain
| | - Ignacio Blanco
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain
| | - Mónica Salinas
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Jaworska-Bieniek
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland144Postgraduate School of Molecular Medicine, Warsaw Medical University, Warsaw, Poland
| | - Katarzyna Durda
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Grzegorz Sukiennicki
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Huzarski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Byrski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Janusz Menkiszak
- Department of Surgical Gynecology and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Adalgeir Arason
- Department of Pathology, Landspitali University Hospital, Reykjavík, Iceland147BMC, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Rosa B Barkardottir
- Department of Pathology, Landspitali University Hospital, Reykjavík, Iceland147BMC, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Jacques Simard
- Canada Research Chair in Oncogenetics, Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec Research Center, Quebec City, Quebec, Canada149Laval University, Quebec City, Quebec, Canada
| | - Rachel Laframboise
- Medical Genetics Division, Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada151Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Simona Agata
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Elisa Alducci
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Ana Peixoto
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal153Biomedical Sciences Institute (ICBAS), University of Porto, Portugal
| | - Amanda B Spurdle
- Department of Genetics and Computational Biology, Queensland Institute of Medical Research, Brisbane, Australia
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University and Hospital, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine and Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Sung-Won Kim
- Department of Surgery, Daerim St Mary's Hospital, Seoul, Korea
| | - Tara M Friebel
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota159Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Noralane M Lindor
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Vernon S Pankratz
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Lucia Guidugli
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Marc Tischkowitz
- Program in Cancer Genetics, Departments of Human Genetics and Oncology, McGill University, Montreal, Quebec, Canada161Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic
| | - Joseph Vijai
- Clinical Genetics Service, Cancer Biology and Genetics Program, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Kenneth Offit
- Clinical Genetics Service, Cancer Biology and Genetics Program, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Mark Robson
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Rohini Rau-Murthy
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Noah Kauff
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Anneliese Fink-Retter
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Christian F Singer
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Christine Rappaport
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | | | - Georg Pfeiler
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Muy-Kheng Tea
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Andreas Berger
- Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Phuong L Mai
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | | | - Amanda Ewart Toland
- Divison of Human Cancer Genetics, Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, Ohio State University, Columbus
| | - Leigha Senter
- Divison of Human Genetics, Department of Internal Medicine, Comprehensive Cancer Center, Ohio State University, Columbus
| | - Anders Bojesen
- Department of Clinical Genetics, Vejle Hospital, Vejle, Denmark
| | - Inge Sokilde Pedersen
- Section of Molecular Diagnostics, Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | | | - Lone Sunde
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus N, Denmark
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odense C, Denmark
| | | | - Torben A Kruse
- Department of Clinical Genetics, Odense University Hospital, Odense C, Denmark
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus N, Denmark
| | - Maria Adelaide Caligo
- Section of Genetic Oncology, Department of Oncology, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Paolo Aretini
- Section of Genetic Oncology, Department of Oncology, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia176Department of Surgery, Faculty of Medicine, University Malaya Cancer Research Institute, University Malaya, Kuala Lumpur, Malaysia
| | - Christina G Selkirk
- NorthShore University HealthSystem, Department of Medicine, Evanston, Illinois
| | - Peter J Hulick
- NorthShore University HealthSystem, Department of Medicine, Evanston, Illinois
| | - Irene Andrulis
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
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Spurdle AB, Couch FJ, Parsons MT, McGuffog L, Barrowdale D, Bolla MK, Wang Q, Healey S, Schmutzler RK, Wappenschmidt B, Rhiem K, Hahnen E, Engel C, Meindl A, Ditsch N, Arnold N, Plendl H, Niederacher D, Sutter C, Wang-Gohrke S, Steinemann D, Preisler-Adams S, Kast K, Varon-Mateeva R, Ellis S, Frost D, Platte R, Perkins J, Evans DG, Izatt L, Eeles R, Adlard J, Davidson R, Cole T, Scuvera G, Manoukian S, Bonanni B, Mariette F, Fortuzzi S, Viel A, Pasini B, Papi L, Varesco L, Balleine R, Nathanson KL, Domchek SM, Offitt K, Jakubowska A, Lindor N, Thomassen M, Jensen UB, Rantala J, Borg Å, Andrulis IL, Miron A, Hansen TVO, Caldes T, Neuhausen SL, Toland AE, Nevanlinna H, Montagna M, Garber J, Godwin AK, Osorio A, Factor RE, Terry MB, Rebbeck TR, Karlan BY, Southey M, Rashid MU, Tung N, Pharoah PDP, Blows FM, Dunning AM, Provenzano E, Hall P, Czene K, Schmidt MK, Broeks A, Cornelissen S, Verhoef S, Fasching PA, Beckmann MW, Ekici AB, Slamon DJ, Bojesen SE, Nordestgaard BG, Nielsen SF, Flyger H, Chang-Claude J, Flesch-Janys D, Rudolph A, Seibold P, Aittomäki K, Muranen TA, Heikkilä P, Blomqvist C, Figueroa J, Chanock SJ, Brinton L, Lissowska J, Olson JE, Pankratz VS, John EM, Whittemore AS, West DW, Hamann U, Torres D, Ulmer HU, Rüdiger T, Devilee P, Tollenaar RAEM, Seynaeve C, Van Asperen CJ, Eccles DM, Tapper WJ, Durcan L, Jones L, Peto J, dos-Santos-Silva I, Fletcher O, Johnson N, Dwek M, Swann R, Bane AL, Glendon G, Mulligan AM, Giles GG, Milne RL, Baglietto L, McLean C, Carpenter J, Clarke C, Scott R, Brauch H, Brüning T, Ko YD, Cox A, Cross SS, Reed MWR, Lubinski J, Jaworska-Bieniek K, Durda K, Gronwald J, Dörk T, Bogdanova N, Park-Simon TW, Hillemanns P, Haiman CA, Henderson BE, Schumacher F, Le Marchand L, Burwinkel B, Marme F, Surovy H, Yang R, Anton-Culver H, Ziogas A, Hooning MJ, Collée JM, Martens JWM, Tilanus-Linthorst MMA, Brenner H, Dieffenbach AK, Arndt V, Stegmaier C, Winqvist R, Pylkäs K, Jukkola-Vuorinen A, Grip M, Lindblom A, Margolin S, Joseph V, Robson M, Rau-Murthy R, González-Neira A, Arias JI, Zamora P, Benítez J, Mannermaa A, Kataja V, Kosma VM, Hartikainen JM, Peterlongo P, Zaffaroni D, Barile M, Capra F, Radice P, Teo SH, Easton DF, Antoniou AC, Chenevix-Trench G, Goldgar DE. Refined histopathological predictors of BRCA1 and BRCA2 mutation status: a large-scale analysis of breast cancer characteristics from the BCAC, CIMBA, and ENIGMA consortia. Breast Cancer Res 2014; 16:3419. [PMID: 25857409 PMCID: PMC4352262 DOI: 10.1186/s13058-014-0474-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 11/05/2014] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The distribution of histopathological features of invasive breast tumors in BRCA1 or BRCA2 germline mutation carriers differs from that of individuals with no known mutation. Histopathological features thus have utility for mutation prediction, including statistical modeling to assess pathogenicity of BRCA1 or BRCA2 variants of uncertain clinical significance. We analyzed large pathology datasets accrued by the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and the Breast Cancer Association Consortium (BCAC) to reassess histopathological predictors of BRCA1 and BRCA2 mutation status, and provide robust likelihood ratio (LR) estimates for statistical modeling. METHODS Selection criteria for study/center inclusion were estrogen receptor (ER) status or grade data available for invasive breast cancer diagnosed younger than 70 years. The dataset included 4,477 BRCA1 mutation carriers, 2,565 BRCA2 mutation carriers, and 47,565 BCAC breast cancer cases. Country-stratified estimates of the likelihood of mutation status by histopathological markers were derived using a Mantel-Haenszel approach. RESULTS ER-positive phenotype negatively predicted BRCA1 mutation status, irrespective of grade (LRs from 0.08 to 0.90). ER-negative grade 3 histopathology was more predictive of positive BRCA1 mutation status in women 50 years or older (LR = 4.13 (3.70 to 4.62)) versus younger than 50 years (LR = 3.16 (2.96 to 3.37)). For BRCA2, ER-positive grade 3 phenotype modestly predicted positive mutation status irrespective of age (LR = 1.7-fold), whereas ER-negative grade 3 features modestly predicted positive mutation status at 50 years or older (LR = 1.54 (1.27 to 1.88)). Triple-negative tumor status was highly predictive of BRCA1 mutation status for women younger than 50 years (LR = 3.73 (3.43 to 4.05)) and 50 years or older (LR = 4.41 (3.86 to 5.04)), and modestly predictive of positive BRCA2 mutation status in women 50 years or older (LR = 1.79 (1.42 to 2.24)). CONCLUSIONS These results refine likelihood-ratio estimates for predicting BRCA1 and BRCA2 mutation status by using commonly measured histopathological features. Age at diagnosis is an important variable for most analyses, and grade is more informative than ER status for BRCA2 mutation carrier prediction. The estimates will improve BRCA1 and BRCA2 variant classification and inform patient mutation testing and clinical management.
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Affiliation(s)
- Amanda B Spurdle
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Daniel Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Sue Healey
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
| | - Rita Katharina Schmutzler
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Barbara Wappenschmidt
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Eric Hahnen
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstrasse 16-18, Leipzig, 04107 Germany
| | - Alfons Meindl
- Division of Gynaecology and Obstetrics, Technische Universität München, Ismaninger Straße 22, Munich, 81675 Germany
| | - Nina Ditsch
- Department of Gynaecology and Obstetrics, Ludwig-Maximilians-Universität, Maistrasse 11, Munich, 80337 Germany
| | - Norbert Arnold
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
| | - Hansjoerg Plendl
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Dieter Niederacher
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Sutter
- Institute of Human Genetics, University Hospital Heidelberg, Im Neuenheimer Feld 366, Heidelberg, 69120 Germany
| | - Shan Wang-Gohrke
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081 Germany
| | - Doris Steinemann
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | | | - Karin Kast
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Steve Ellis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Radka Platte
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jo Perkins
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - D Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Louise Izatt
- Clinical Genetics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Ros Eeles
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
| | - Rosemarie Davidson
- Department of Clinical Genetics, Southern General Hospital, 1345 Glovan Rd, Glasgow, G51 4TF UK
| | - Trevor Cole
- West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham UK
| | - Giulietta Scuvera
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti, 435, Milan, 20141 Italy
| | - Frederique Mariette
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
| | - Stefano Fortuzzi
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
| | - Alessandra Viel
- Division of Experimental Oncology 1, CRO Aviano National Cancer Institute, Via Franco Gallini 2, Aviano, 33081 PN Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Via Santena 19, Turin, 10126 Italy
- AOU Città della Salute e della Scienza, corso Bramante 88, 10126 Turin Italy
| | - Laura Papi
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Pieraccini 6, Florence, 50139 Italy
| | - Liliana Varesco
- Unit of Hereditary Cancer, IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, largo Rosanna Benzi 10, Genoa, 16132 Italy
| | - Rosemary Balleine
- Western Sydney and Nepean Blue Mountains Local Health Districts, Westmead Millennium Institute for Medical Research, University of Sydney, 176 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Katherine L Nathanson
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
| | - Susan M Domchek
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
| | - Kenneth Offitt
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
| | - Noralane Lindor
- Department of Health Sciences Research, Mayo Clinic, 13400 E. Scottsdale Blvd., Scottsdale, AZ USA
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense, C, Denmark
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus, N, Denmark
| | - Johanna Rantala
- Department of Clinical Genetics, Karolinska University Hospital L5:03, Stockholm, S-171 76 Sweden
| | - Åke Borg
- Department of Oncology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
| | - Irene L Andrulis
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
| | - Alexander Miron
- Department of Genetics and Genome Services, Case Western Reserve University Medical School, 2109 Adelbert Rd, Cleveland, 44106-4955 OH USA
| | - Thomas VO Hansen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100 Denmark
| | - Trinidad Caldes
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Martin Lagos s/n, Madrid, Spain
| | - Susan L Neuhausen
- Beckman Research Institute of City of Hope, 1500 East Duarte Rd, Duarte, 91010 CA USA
| | - Amanda E Toland
- Divison of Human Cancer Genetics, Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State Universit, 998 Biomedical Research Tower, Columbus, OH USA
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, Padua, Italy
| | - Judy Garber
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA USA
| | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard,4019 Wahl Hall East, Kansas, MS 3040 KS USA
| | - Ana Osorio
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, Madrid, 28029 Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Rachel E Factor
- Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, 84132 UT USA
| | - Mary B Terry
- Department of Epidemiology, Columbia University, New York, NY USA
| | - Timothy R Rebbeck
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
| | - Beth Y Karlan
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 W, Los Angeles, CA USA
| | - Melissa Southey
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Parkville, Victoria Australia
| | - Muhammad Usman Rashid
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC) 7A, Block R3, Johar, Pakistan
| | | | - Paul DP Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Fiona M Blows
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
| | - Marjanka K Schmidt
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
| | - Annegien Broeks
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
| | - Sten Cornelissen
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
| | - Senno Verhoef
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, 90095 CA USA
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen, 91054 Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen, 91054 Germany
| | - Arif B Ekici
- Institute of Human Genetics, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Schlossplatz 4, Erlangen, 91054 Germany
| | - Dennis J Slamon
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, 90095 CA USA
- Jonsson Comprehensive Cancer Center, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, 90024 CA USA
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, 2200 Denmark
| | - Børge G Nordestgaard
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, 2200 Denmark
| | - Sune F Nielsen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
| | - Henrik Flyger
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Dieter Flesch-Janys
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246 Germany
| | - Anja Rudolph
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Kristiina Aittomäki
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
| | - Taru A Muranen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
| | - Päivi Heikkilä
- Department of Pathology, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS, Finland
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
| | - Louise Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
| | - Vernon S Pankratz
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
| | - Esther M John
- Cancer Prevention Institute of California, 2201 Walnut Avenue #300, Fremont, 94538 CA USA
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
| | - Alice S Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
| | - Dee W West
- Cancer Prevention Institute of California, 2201 Walnut Avenue #300, Fremont, 94538 CA USA
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
| | - Diana Torres
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
- Institute of Human Genetics, Pontificia University Javeriana, Carrera 7, Bogotá, 11001000 DC Colombia
| | - Hans Ulrich Ulmer
- Frauenklinik der Stadtklinik Baden-Baden, Balger Straße 50, Baden-Baden, 76532 Germany
| | - Thomas Rüdiger
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Moltkestraße 90, Karlsruhe, 76133 Germany
| | - Peter Devilee
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
| | - Robert AEM Tollenaar
- Department of Surgical Oncology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
| | - Caroline Seynaeve
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centrer, Groene Hilledijk 301, EA Rotterdam, 3075 Netherlands
| | - Christi J Van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Einthovenweg 20, ZC Leiden, 2333 Netherlands
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
| | - William J Tapper
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
| | - Lorraine Durcan
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
| | - Louise Jones
- Queen Mary University London, Mile End Road, London, E1 4NS England
| | - Julian Peto
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Isabel dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Olivia Fletcher
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB UK
| | - Nichola Johnson
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB UK
| | - Miriam Dwek
- Department of Molecular and Applied Biosciences, Faculty of Science and Technology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW UK
| | - Ruth Swann
- Department of Molecular and Applied Biosciences, Faculty of Science and Technology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW UK
| | - Anita L Bane
- Department of Pathology & Molecular Medicine, Juravinski Hospital, Concession St, Hamilton, L8V 1C3 Ontario Canada
- Cancer Centre, McMaster University, Hamilton, L8V 1C4 ON Canada
| | - Gord Glendon
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
| | - Anna M Mulligan
- Department of Pathology, University Health Network, Toronto, M5G 2C4 ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
| | - Roger L Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
| | - Catriona McLean
- Anatomical Pathology, The Alfred Hospital, 55 Commercial Rd, Melbourne, 3004 Victoria Australia
| | - Jane Carpenter
- Australian Breast Cancer Tissue Bank, Westmead Millennium Institute, University of Sydney, Darcy Rd, Sydney, NSW 2145 Australia
| | - Christine Clarke
- Westmead Institute for Cancer Research, University of Sydney, Darcy Road, Sydney, NSW 2145 Australia
| | - Rodney Scott
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW 2305 Australia
- Division of Genetics, Hunter Area Pathology Service, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW 2305 Australia
| | - Hiltrud Brauch
- University of Tübingen, Geschwister-Scholl-Platz, Tübingen, 72074 Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstraße 112, Stuttgart, 70376 Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Bürkle-de-la-Camp-Platz 1, Bochum, 44789 Germany
| | - Yon-Dschun Ko
- Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Johanniterstraße 3, Bonn, 53113 Germany
| | - Angela Cox
- Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ UK
| | - Malcolm WR Reed
- Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
| | - Katarzyna Jaworska-Bieniek
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
| | - Katarzyna Durda
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
| | - Thilo Dörk
- Clinics of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
| | - Natalia Bogdanova
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
| | - Tjoung-Won Park-Simon
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
| | - Peter Hillemanns
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
| | - Brian E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
| | - Fredrick Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
| | - Loic Le Marchand
- Epidemiology Program, Cancer Research Center, University of Hawaii, 701 Ilalo Street, Honolulu, 96813 HI USA
| | - Barbara Burwinkel
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Frederik Marme
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- National Center for Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Harald Surovy
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Rongxi Yang
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, 92697 CA USA
| | - Argyrios Ziogas
- Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, 92697 CA USA
| | - Maartje J Hooning
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3008 AE Netherlands
| | - J Margriet Collée
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3000 CA Netherlands
| | - John WM Martens
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3008 AE Netherlands
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Aida Karina Dieffenbach
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Volke Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
| | - Christa Stegmaier
- Saarland Cancer Registry, Präsident-Baltz-Straße 5, Saarbrücken, 66119 Germany
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, NordLab Oulu/Oulu University Hospital, Aapistie 5A, Oulu, FI-90220 Finland
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, NordLab Oulu/Oulu University Hospital, Aapistie 5A, Oulu, FI-90220 Finland
| | - Arja Jukkola-Vuorinen
- Department of Oncology, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
| | - Sara Margolin
- Department of Oncology and Pathology, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
| | - Vijai Joseph
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
| | - Mark Robson
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
| | - Rohini Rau-Murthy
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
| | - Anna González-Neira
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, 28029 Madrid, Spain
| | - José Ignacio Arias
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Av Doctores Fernández Vega, 107, Oviedo, 33012 Asturias, Spain
| | - Pilar Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid, 28046 Spain
| | - Javier Benítez
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, Madrid, 28029 Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | - Arto Mannermaa
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
| | - Vesa Kataja
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Cancer Center, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
| | - Veli-Matti Kosma
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
| | - Jaana M Hartikainen
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
| | - Paolo Peterlongo
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
| | - Daniela Zaffaroni
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
| | - Monica Barile
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti, 435, Milan, 20141 Italy
| | - Fabio Capra
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian 1, Milan, 20133 Italy
| | - Soo H Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS 12/1a, Ss 12, Subang Jaya, Selangor Malaysia
- Faculty of Medicine, University Malaya Cancer Research Institute, University Malaya, Kuala Lumpur, 50603 Malaysia
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
| | - David E Goldgar
- Department of Dermatology and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, 84112 UT USA
| | - EMBRACE Group
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstrasse 16-18, Leipzig, 04107 Germany
- Division of Gynaecology and Obstetrics, Technische Universität München, Ismaninger Straße 22, Munich, 81675 Germany
- Department of Gynaecology and Obstetrics, Ludwig-Maximilians-Universität, Maistrasse 11, Munich, 80337 Germany
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- University Medical Center Schleswig-Holstein, Kiel, Germany
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Human Genetics, University Hospital Heidelberg, Im Neuenheimer Feld 366, Heidelberg, 69120 Germany
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081 Germany
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
- Institute of Human Genetics, University of Münster, Münster, Germany
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Institute of Human Genetics, Campus Virchov Klinikum, Charite Berlin, Germany
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
- Department of Clinical Genetics, Southern General Hospital, 1345 Glovan Rd, Glasgow, G51 4TF UK
- West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham UK
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti, 435, Milan, 20141 Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
- Division of Experimental Oncology 1, CRO Aviano National Cancer Institute, Via Franco Gallini 2, Aviano, 33081 PN Italy
- Department of Medical Sciences, University of Turin, Via Santena 19, Turin, 10126 Italy
- AOU Città della Salute e della Scienza, corso Bramante 88, 10126 Turin Italy
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Pieraccini 6, Florence, 50139 Italy
- Unit of Hereditary Cancer, IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, largo Rosanna Benzi 10, Genoa, 16132 Italy
- Western Sydney and Nepean Blue Mountains Local Health Districts, Westmead Millennium Institute for Medical Research, University of Sydney, 176 Hawkesbury Rd, Westmead, NSW 2145 Australia
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
- Department of Health Sciences Research, Mayo Clinic, 13400 E. Scottsdale Blvd., Scottsdale, AZ USA
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense, C, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus, N, Denmark
- Department of Clinical Genetics, Karolinska University Hospital L5:03, Stockholm, S-171 76 Sweden
- Department of Oncology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Genetics and Genome Services, Case Western Reserve University Medical School, 2109 Adelbert Rd, Cleveland, 44106-4955 OH USA
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100 Denmark
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Martin Lagos s/n, Madrid, Spain
- Beckman Research Institute of City of Hope, 1500 East Duarte Rd, Duarte, 91010 CA USA
- Divison of Human Cancer Genetics, Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State Universit, 998 Biomedical Research Tower, Columbus, OH USA
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, Padua, Italy
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA USA
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard,4019 Wahl Hall East, Kansas, MS 3040 KS USA
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, Madrid, 28029 Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
- Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, 84132 UT USA
- Department of Epidemiology, Columbia University, New York, NY USA
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 W, Los Angeles, CA USA
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Parkville, Victoria Australia
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC) 7A, Block R3, Johar, Pakistan
- 331 Brookline Avenue, Boston, 02215 MA USA
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, 90095 CA USA
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen, 91054 Germany
- Institute of Human Genetics, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Schlossplatz 4, Erlangen, 91054 Germany
- Jonsson Comprehensive Cancer Center, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, 90024 CA USA
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, 2200 Denmark
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246 Germany
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Pathology, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS, Finland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Cancer Prevention Institute of California, 2201 Walnut Avenue #300, Fremont, 94538 CA USA
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
- Institute of Human Genetics, Pontificia University Javeriana, Carrera 7, Bogotá, 11001000 DC Colombia
- Frauenklinik der Stadtklinik Baden-Baden, Balger Straße 50, Baden-Baden, 76532 Germany
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Moltkestraße 90, Karlsruhe, 76133 Germany
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centrer, Groene Hilledijk 301, EA Rotterdam, 3075 Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Einthovenweg 20, ZC Leiden, 2333 Netherlands
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
- Queen Mary University London, Mile End Road, London, E1 4NS England
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB UK
- Department of Molecular and Applied Biosciences, Faculty of Science and Technology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW UK
- Department of Pathology & Molecular Medicine, Juravinski Hospital, Concession St, Hamilton, L8V 1C3 Ontario Canada
- Cancer Centre, McMaster University, Hamilton, L8V 1C4 ON Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Pathology, University Health Network, Toronto, M5G 2C4 ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
- Anatomical Pathology, The Alfred Hospital, 55 Commercial Rd, Melbourne, 3004 Victoria Australia
- Australian Breast Cancer Tissue Bank, Westmead Millennium Institute, University of Sydney, Darcy Rd, Sydney, NSW 2145 Australia
- Westmead Institute for Cancer Research, University of Sydney, Darcy Road, Sydney, NSW 2145 Australia
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW 2305 Australia
- Division of Genetics, Hunter Area Pathology Service, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW 2305 Australia
- University of Tübingen, Geschwister-Scholl-Platz, Tübingen, 72074 Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstraße 112, Stuttgart, 70376 Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Bürkle-de-la-Camp-Platz 1, Bochum, 44789 Germany
- Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Johanniterstraße 3, Bonn, 53113 Germany
- Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ UK
- Clinics of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
- Epidemiology Program, Cancer Research Center, University of Hawaii, 701 Ilalo Street, Honolulu, 96813 HI USA
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- National Center for Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, 92697 CA USA
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3008 AE Netherlands
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3000 CA Netherlands
- Department of Surgical Oncology, Erasmus University Medical Center, Doctor Molewaterplein 50-60, Rotterdam, Netherlands
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Saarland Cancer Registry, Präsident-Baltz-Straße 5, Saarbrücken, 66119 Germany
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, NordLab Oulu/Oulu University Hospital, Aapistie 5A, Oulu, FI-90220 Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Department of Oncology and Pathology, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, 28029 Madrid, Spain
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Av Doctores Fernández Vega, 107, Oviedo, 33012 Asturias, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid, 28046 Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Valencia, Spain
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Cancer Center, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian 1, Milan, 20133 Italy
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS 12/1a, Ss 12, Subang Jaya, Selangor Malaysia
- Faculty of Medicine, University Malaya Cancer Research Institute, University Malaya, Kuala Lumpur, 50603 Malaysia
- Department of Dermatology and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, 84112 UT USA
| | - GENICA Network
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstrasse 16-18, Leipzig, 04107 Germany
- Division of Gynaecology and Obstetrics, Technische Universität München, Ismaninger Straße 22, Munich, 81675 Germany
- Department of Gynaecology and Obstetrics, Ludwig-Maximilians-Universität, Maistrasse 11, Munich, 80337 Germany
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- University Medical Center Schleswig-Holstein, Kiel, Germany
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Human Genetics, University Hospital Heidelberg, Im Neuenheimer Feld 366, Heidelberg, 69120 Germany
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081 Germany
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
- Institute of Human Genetics, University of Münster, Münster, Germany
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Institute of Human Genetics, Campus Virchov Klinikum, Charite Berlin, Germany
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
- Department of Clinical Genetics, Southern General Hospital, 1345 Glovan Rd, Glasgow, G51 4TF UK
- West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham UK
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti, 435, Milan, 20141 Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
- Division of Experimental Oncology 1, CRO Aviano National Cancer Institute, Via Franco Gallini 2, Aviano, 33081 PN Italy
- Department of Medical Sciences, University of Turin, Via Santena 19, Turin, 10126 Italy
- AOU Città della Salute e della Scienza, corso Bramante 88, 10126 Turin Italy
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Pieraccini 6, Florence, 50139 Italy
- Unit of Hereditary Cancer, IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, largo Rosanna Benzi 10, Genoa, 16132 Italy
- Western Sydney and Nepean Blue Mountains Local Health Districts, Westmead Millennium Institute for Medical Research, University of Sydney, 176 Hawkesbury Rd, Westmead, NSW 2145 Australia
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
- Department of Health Sciences Research, Mayo Clinic, 13400 E. Scottsdale Blvd., Scottsdale, AZ USA
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense, C, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus, N, Denmark
- Department of Clinical Genetics, Karolinska University Hospital L5:03, Stockholm, S-171 76 Sweden
- Department of Oncology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Genetics and Genome Services, Case Western Reserve University Medical School, 2109 Adelbert Rd, Cleveland, 44106-4955 OH USA
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100 Denmark
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Martin Lagos s/n, Madrid, Spain
- Beckman Research Institute of City of Hope, 1500 East Duarte Rd, Duarte, 91010 CA USA
- Divison of Human Cancer Genetics, Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State Universit, 998 Biomedical Research Tower, Columbus, OH USA
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, Padua, Italy
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA USA
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard,4019 Wahl Hall East, Kansas, MS 3040 KS USA
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, Madrid, 28029 Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
- Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, 84132 UT USA
- Department of Epidemiology, Columbia University, New York, NY USA
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 W, Los Angeles, CA USA
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Parkville, Victoria Australia
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC) 7A, Block R3, Johar, Pakistan
- 331 Brookline Avenue, Boston, 02215 MA USA
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, 90095 CA USA
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen, 91054 Germany
- Institute of Human Genetics, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Schlossplatz 4, Erlangen, 91054 Germany
- Jonsson Comprehensive Cancer Center, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, 90024 CA USA
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, 2200 Denmark
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246 Germany
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Pathology, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS, Finland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Cancer Prevention Institute of California, 2201 Walnut Avenue #300, Fremont, 94538 CA USA
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
- Institute of Human Genetics, Pontificia University Javeriana, Carrera 7, Bogotá, 11001000 DC Colombia
- Frauenklinik der Stadtklinik Baden-Baden, Balger Straße 50, Baden-Baden, 76532 Germany
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Moltkestraße 90, Karlsruhe, 76133 Germany
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centrer, Groene Hilledijk 301, EA Rotterdam, 3075 Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Einthovenweg 20, ZC Leiden, 2333 Netherlands
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
- Queen Mary University London, Mile End Road, London, E1 4NS England
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB UK
- Department of Molecular and Applied Biosciences, Faculty of Science and Technology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW UK
- Department of Pathology & Molecular Medicine, Juravinski Hospital, Concession St, Hamilton, L8V 1C3 Ontario Canada
- Cancer Centre, McMaster University, Hamilton, L8V 1C4 ON Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Pathology, University Health Network, Toronto, M5G 2C4 ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
- Anatomical Pathology, The Alfred Hospital, 55 Commercial Rd, Melbourne, 3004 Victoria Australia
- Australian Breast Cancer Tissue Bank, Westmead Millennium Institute, University of Sydney, Darcy Rd, Sydney, NSW 2145 Australia
- Westmead Institute for Cancer Research, University of Sydney, Darcy Road, Sydney, NSW 2145 Australia
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW 2305 Australia
- Division of Genetics, Hunter Area Pathology Service, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW 2305 Australia
- University of Tübingen, Geschwister-Scholl-Platz, Tübingen, 72074 Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstraße 112, Stuttgart, 70376 Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Bürkle-de-la-Camp-Platz 1, Bochum, 44789 Germany
- Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Johanniterstraße 3, Bonn, 53113 Germany
- Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ UK
- Clinics of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
- Epidemiology Program, Cancer Research Center, University of Hawaii, 701 Ilalo Street, Honolulu, 96813 HI USA
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- National Center for Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, 92697 CA USA
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3008 AE Netherlands
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3000 CA Netherlands
- Department of Surgical Oncology, Erasmus University Medical Center, Doctor Molewaterplein 50-60, Rotterdam, Netherlands
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Saarland Cancer Registry, Präsident-Baltz-Straße 5, Saarbrücken, 66119 Germany
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, NordLab Oulu/Oulu University Hospital, Aapistie 5A, Oulu, FI-90220 Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Department of Oncology and Pathology, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, 28029 Madrid, Spain
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Av Doctores Fernández Vega, 107, Oviedo, 33012 Asturias, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid, 28046 Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Valencia, Spain
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Cancer Center, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian 1, Milan, 20133 Italy
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS 12/1a, Ss 12, Subang Jaya, Selangor Malaysia
- Faculty of Medicine, University Malaya Cancer Research Institute, University Malaya, Kuala Lumpur, 50603 Malaysia
- Department of Dermatology and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, 84112 UT USA
| | - HEBON Group
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstrasse 16-18, Leipzig, 04107 Germany
- Division of Gynaecology and Obstetrics, Technische Universität München, Ismaninger Straße 22, Munich, 81675 Germany
- Department of Gynaecology and Obstetrics, Ludwig-Maximilians-Universität, Maistrasse 11, Munich, 80337 Germany
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- University Medical Center Schleswig-Holstein, Kiel, Germany
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Human Genetics, University Hospital Heidelberg, Im Neuenheimer Feld 366, Heidelberg, 69120 Germany
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081 Germany
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
- Institute of Human Genetics, University of Münster, Münster, Germany
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Institute of Human Genetics, Campus Virchov Klinikum, Charite Berlin, Germany
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
- Department of Clinical Genetics, Southern General Hospital, 1345 Glovan Rd, Glasgow, G51 4TF UK
- West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham UK
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti, 435, Milan, 20141 Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
- Division of Experimental Oncology 1, CRO Aviano National Cancer Institute, Via Franco Gallini 2, Aviano, 33081 PN Italy
- Department of Medical Sciences, University of Turin, Via Santena 19, Turin, 10126 Italy
- AOU Città della Salute e della Scienza, corso Bramante 88, 10126 Turin Italy
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Pieraccini 6, Florence, 50139 Italy
- Unit of Hereditary Cancer, IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, largo Rosanna Benzi 10, Genoa, 16132 Italy
- Western Sydney and Nepean Blue Mountains Local Health Districts, Westmead Millennium Institute for Medical Research, University of Sydney, 176 Hawkesbury Rd, Westmead, NSW 2145 Australia
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
- Department of Health Sciences Research, Mayo Clinic, 13400 E. Scottsdale Blvd., Scottsdale, AZ USA
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense, C, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus, N, Denmark
- Department of Clinical Genetics, Karolinska University Hospital L5:03, Stockholm, S-171 76 Sweden
- Department of Oncology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Genetics and Genome Services, Case Western Reserve University Medical School, 2109 Adelbert Rd, Cleveland, 44106-4955 OH USA
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100 Denmark
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Martin Lagos s/n, Madrid, Spain
- Beckman Research Institute of City of Hope, 1500 East Duarte Rd, Duarte, 91010 CA USA
- Divison of Human Cancer Genetics, Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State Universit, 998 Biomedical Research Tower, Columbus, OH USA
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, Padua, Italy
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA USA
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard,4019 Wahl Hall East, Kansas, MS 3040 KS USA
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, Madrid, 28029 Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
- Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, 84132 UT USA
- Department of Epidemiology, Columbia University, New York, NY USA
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 W, Los Angeles, CA USA
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Parkville, Victoria Australia
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC) 7A, Block R3, Johar, Pakistan
- 331 Brookline Avenue, Boston, 02215 MA USA
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, 90095 CA USA
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen, 91054 Germany
- Institute of Human Genetics, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Schlossplatz 4, Erlangen, 91054 Germany
- Jonsson Comprehensive Cancer Center, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, 90024 CA USA
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, 2200 Denmark
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246 Germany
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Pathology, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS, Finland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Cancer Prevention Institute of California, 2201 Walnut Avenue #300, Fremont, 94538 CA USA
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
- Institute of Human Genetics, Pontificia University Javeriana, Carrera 7, Bogotá, 11001000 DC Colombia
- Frauenklinik der Stadtklinik Baden-Baden, Balger Straße 50, Baden-Baden, 76532 Germany
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Moltkestraße 90, Karlsruhe, 76133 Germany
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centrer, Groene Hilledijk 301, EA Rotterdam, 3075 Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Einthovenweg 20, ZC Leiden, 2333 Netherlands
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
- Queen Mary University London, Mile End Road, London, E1 4NS England
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB UK
- Department of Molecular and Applied Biosciences, Faculty of Science and Technology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW UK
- Department of Pathology & Molecular Medicine, Juravinski Hospital, Concession St, Hamilton, L8V 1C3 Ontario Canada
- Cancer Centre, McMaster University, Hamilton, L8V 1C4 ON Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Pathology, University Health Network, Toronto, M5G 2C4 ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
- Anatomical Pathology, The Alfred Hospital, 55 Commercial Rd, Melbourne, 3004 Victoria Australia
- Australian Breast Cancer Tissue Bank, Westmead Millennium Institute, University of Sydney, Darcy Rd, Sydney, NSW 2145 Australia
- Westmead Institute for Cancer Research, University of Sydney, Darcy Road, Sydney, NSW 2145 Australia
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW 2305 Australia
- Division of Genetics, Hunter Area Pathology Service, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW 2305 Australia
- University of Tübingen, Geschwister-Scholl-Platz, Tübingen, 72074 Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstraße 112, Stuttgart, 70376 Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Bürkle-de-la-Camp-Platz 1, Bochum, 44789 Germany
- Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Johanniterstraße 3, Bonn, 53113 Germany
- Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ UK
- Clinics of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
- Epidemiology Program, Cancer Research Center, University of Hawaii, 701 Ilalo Street, Honolulu, 96813 HI USA
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- National Center for Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, 92697 CA USA
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3008 AE Netherlands
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3000 CA Netherlands
- Department of Surgical Oncology, Erasmus University Medical Center, Doctor Molewaterplein 50-60, Rotterdam, Netherlands
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Saarland Cancer Registry, Präsident-Baltz-Straße 5, Saarbrücken, 66119 Germany
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, NordLab Oulu/Oulu University Hospital, Aapistie 5A, Oulu, FI-90220 Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Department of Oncology and Pathology, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, 28029 Madrid, Spain
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Av Doctores Fernández Vega, 107, Oviedo, 33012 Asturias, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid, 28046 Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Valencia, Spain
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Cancer Center, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian 1, Milan, 20133 Italy
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS 12/1a, Ss 12, Subang Jaya, Selangor Malaysia
- Faculty of Medicine, University Malaya Cancer Research Institute, University Malaya, Kuala Lumpur, 50603 Malaysia
- Department of Dermatology and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, 84112 UT USA
| | - kConFab Investigators
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, 4006 QLD Australia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital Cologne, Cologne, Germany
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstrasse 16-18, Leipzig, 04107 Germany
- Division of Gynaecology and Obstetrics, Technische Universität München, Ismaninger Straße 22, Munich, 81675 Germany
- Department of Gynaecology and Obstetrics, Ludwig-Maximilians-Universität, Maistrasse 11, Munich, 80337 Germany
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
- University Medical Center Schleswig-Holstein, Kiel, Germany
- Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Human Genetics, University Hospital Heidelberg, Im Neuenheimer Feld 366, Heidelberg, 69120 Germany
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, 89081 Germany
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
- Institute of Human Genetics, University of Münster, Münster, Germany
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Institute of Human Genetics, Campus Virchov Klinikum, Charite Berlin, Germany
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Clinical Genetics, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK
- Department of Clinical Genetics, Southern General Hospital, 1345 Glovan Rd, Glasgow, G51 4TF UK
- West Midlands Regional Genetics Service, Birmingham Women’s Hospital Healthcare NHS Trust, Edgbaston, Birmingham UK
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian, 1, Milan, 20133 Italy
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Via Giuseppe Ripamonti, 435, Milan, 20141 Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Via Adamello, 16, Milan, 20139 Italy
- Cogentech Cancer Genetic Test Laboratory, Via Adamello, 16, Milan, 20139 Italy
- Division of Experimental Oncology 1, CRO Aviano National Cancer Institute, Via Franco Gallini 2, Aviano, 33081 PN Italy
- Department of Medical Sciences, University of Turin, Via Santena 19, Turin, 10126 Italy
- AOU Città della Salute e della Scienza, corso Bramante 88, 10126 Turin Italy
- Unit of Medical Genetics, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Pieraccini 6, Florence, 50139 Italy
- Unit of Hereditary Cancer, IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, largo Rosanna Benzi 10, Genoa, 16132 Italy
- Western Sydney and Nepean Blue Mountains Local Health Districts, Westmead Millennium Institute for Medical Research, University of Sydney, 176 Hawkesbury Rd, Westmead, NSW 2145 Australia
- Abramson Cancer Center, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, 19104 PA USA
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 417 East 68th Street, New York, 10021 NY USA
- Department of Genetics and Pathology, Pomeranian Medical University, Połabska 4, Szczecin, 70-115 Poland
- Department of Health Sciences Research, Mayo Clinic, 13400 E. Scottsdale Blvd., Scottsdale, AZ USA
- Department of Clinical Genetics, Odense University Hospital, Sonder Boulevard 29, Odense, C, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Brendstrupgaardsvej 21C, Aarhus, N, Denmark
- Department of Clinical Genetics, Karolinska University Hospital L5:03, Stockholm, S-171 76 Sweden
- Department of Oncology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Genetics and Genome Services, Case Western Reserve University Medical School, 2109 Adelbert Rd, Cleveland, 44106-4955 OH USA
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, DK-2100 Denmark
- Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, Martin Lagos s/n, Madrid, Spain
- Beckman Research Institute of City of Hope, 1500 East Duarte Rd, Duarte, 91010 CA USA
- Divison of Human Cancer Genetics, Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State Universit, 998 Biomedical Research Tower, Columbus, OH USA
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, Padua, Italy
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA USA
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard,4019 Wahl Hall East, Kansas, MS 3040 KS USA
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, Madrid, 28029 Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
- Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, 84132 UT USA
- Department of Epidemiology, Columbia University, New York, NY USA
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 290 W, Los Angeles, CA USA
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Parkville, Victoria Australia
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 580, Heidelberg, 69120 Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC) 7A, Block R3, Johar, Pakistan
- 331 Brookline Avenue, Boston, 02215 MA USA
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, 1066 CX Netherlands
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, 10833 Le Conte Avenue, Los Angeles, 90095 CA USA
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstrasse 21-23, Erlangen, 91054 Germany
- Institute of Human Genetics, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg, Schlossplatz 4, Erlangen, 91054 Germany
- Jonsson Comprehensive Cancer Center, University of California-Los Angeles, 10833 Le Conte Ave, Los Angeles, 90024 CA USA
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, 2200 Denmark
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 74, Herlev, 2730 Denmark
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246 Germany
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Pathology, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS Finland
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, FI-00029 HUS, Finland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, 20850 MD USA
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN USA
- Cancer Prevention Institute of California, 2201 Walnut Avenue #300, Fremont, 94538 CA USA
- Department of Health Research and Policy, Stanford University School of Medicine, 291 Campus Drive, Stanford, 94305 CA USA
- Institute of Human Genetics, Pontificia University Javeriana, Carrera 7, Bogotá, 11001000 DC Colombia
- Frauenklinik der Stadtklinik Baden-Baden, Balger Straße 50, Baden-Baden, 76532 Germany
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Moltkestraße 90, Karlsruhe, 76133 Germany
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Einthovenweg 20, Leiden, 2333 ZC Netherlands
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centrer, Groene Hilledijk 301, EA Rotterdam, 3075 Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Einthovenweg 20, ZC Leiden, 2333 Netherlands
- Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ England
- Queen Mary University London, Mile End Road, London, E1 4NS England
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB UK
- Department of Molecular and Applied Biosciences, Faculty of Science and Technology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW UK
- Department of Pathology & Molecular Medicine, Juravinski Hospital, Concession St, Hamilton, L8V 1C3 Ontario Canada
- Cancer Centre, McMaster University, Hamilton, L8V 1C4 ON Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5 ON Canada
- Department of Pathology, University Health Network, Toronto, M5G 2C4 ON Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, M5S 1A8 ON Canada
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, 3004 Victoria Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, The University of Melbourne, Level 1, 723 Swanston Street, Melbourne, 3010 Victoria Australia
- Anatomical Pathology, The Alfred Hospital, 55 Commercial Rd, Melbourne, 3004 Victoria Australia
- Australian Breast Cancer Tissue Bank, Westmead Millennium Institute, University of Sydney, Darcy Rd, Sydney, NSW 2145 Australia
- Westmead Institute for Cancer Research, University of Sydney, Darcy Road, Sydney, NSW 2145 Australia
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW 2305 Australia
- Division of Genetics, Hunter Area Pathology Service, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle, NSW 2305 Australia
- University of Tübingen, Geschwister-Scholl-Platz, Tübingen, 72074 Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstraße 112, Stuttgart, 70376 Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Bürkle-de-la-Camp-Platz 1, Bochum, 44789 Germany
- Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Johanniterstraße 3, Bonn, 53113 Germany
- Department of Oncology, CRUK/YCR Sheffield Cancer Research Centre, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, 385a Glossop Road, Sheffield, S10 2HQ UK
- Clinics of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Obstetrics and Gynaecology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625 Germany
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Health Science Campus, 1975 San Pablo St., Los Angeles, 90033 CA USA
- Epidemiology Program, Cancer Research Center, University of Hawaii, 701 Ilalo Street, Honolulu, 96813 HI USA
- Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 672, Heidelberg, 69120 Germany
- Molecular Epidemiology Group,, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- National Center for Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, 92697 CA USA
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3008 AE Netherlands
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, 3000 CA Netherlands
- Department of Surgical Oncology, Erasmus University Medical Center, Doctor Molewaterplein 50-60, Rotterdam, Netherlands
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120 Germany
- Saarland Cancer Registry, Präsident-Baltz-Straße 5, Saarbrücken, 66119 Germany
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, NordLab Oulu/Oulu University Hospital, Aapistie 5A, Oulu, FI-90220 Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Kajaanintie 50, Oulu, FI-90220 Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Department of Oncology and Pathology, Karolinska Institutet, Nobels väg 12A, Stockholm, SE-17177 Sweden
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), C/Melchor Fernández, Almagro 3, 28029 Madrid, Spain
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Av Doctores Fernández Vega, 107, Oviedo, 33012 Asturias, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid, 28046 Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Valencia, Spain
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Yliopistonranta 1C, Kuopio, FI-70211 Finland
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Cancer Center, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, 70210 Finland
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Via Giacomo Venezian 1, Milan, 20133 Italy
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, 1 Jalan SS 12/1a, Ss 12, Subang Jaya, Selangor Malaysia
- Faculty of Medicine, University Malaya Cancer Research Institute, University Malaya, Kuala Lumpur, 50603 Malaysia
- Department of Dermatology and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, 84112 UT USA
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Frigerio S, Disciglio V, Manoukian S, Peissel B, Della Torre G, Maurichi A, Collini P, Pasini B, Gotti G, Ferrari A, Rivoltini L, Massimino M, Rodolfo M. A large de novo 9p21.3 deletion in a girl affected by astrocytoma and multiple melanoma. BMC Med Genet 2014; 15:59. [PMID: 24884915 PMCID: PMC4036080 DOI: 10.1186/1471-2350-15-59] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 05/05/2014] [Indexed: 11/10/2022]
Abstract
Background Association of melanoma, neural system tumors and germ line mutations at the 9p21 region in the CDKN2A, CDKN2B and CDKN2BAS genes has been reported in a small number of families worldwide and described as a discrete syndrome in melanoma families registered as a rare disease, the melanoma–astrocytoma syndrome. Case presentation We here studied two young patients developing melanoma after radiotherapy for astrocytoma, both reporting lack of family history for melanoma or neural system tumors at genetic counselling. Patient A is a girl treated for anaplastic astrocytoma at 10 years and for multiple melanomas on the scalp associated to dysplastic nevi two years later. Her monozygotic twin sister carried dysplastic nevi and a slow growing, untreated cerebral lesion. Direct sequencing analysis showed no alterations in melanoma susceptibility genes including CDKN2A, CDK4, MC1R and MITF or in TP53. By microsatellite analysis, multiplex ligation-dependent probe amplification, and array comparative genomic hybridization a deletion including the CDKN2A, CDKN2B and CDKN2BAS gene cluster was detected in both twin sisters, encompassing a large region at 9p21.3 and occurring de novo after the loss of one paternal allele. Patient B is a boy of 7 years when treated for astrocytoma then developing melanoma associated to congenital nevi on the head 10 years later: sequencing and multiplex ligation-dependent probe amplification revealed a normal profile of the CDKN2A/CDKN2B/CDKN2BAS region. Array comparative genomic hybridization confirmed the absence of deletions at 9p21.3 and failed to reveal known pathogenic copy number variations. Conclusions By comparison with the other germ line deletions at the CDKN2A, CDKN2B and CDKN2BAS gene cluster reported in melanoma susceptible families, the deletion detected in the two sisters is peculiar for its de novo origin and for its extension, as it represents the largest constitutive deletion at 9p21.3 region identified so far. In addition, the two studied cases add to other evidence indicating association of melanoma with exposure to ionizing radiation and with second neoplasm after childhood cancer. Melanoma should be considered in the monitoring of pigmented lesions in young cancer patients.
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Affiliation(s)
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- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan 20133, Italy.
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