Cited by 83BRCA gene mutations in cancerGenetic factors in colorectal cancerBreast Lesions and Carcinomas

Are the so-called low penetrance breast cancer genes, ATM, BRIP1, PALB2 and CHEK2, high risk for women with strong family histories?

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Byrnes, Graham B, Southey, Melissa C, Hopper, John L·2008·Breast Cancer Research

Abstract

A woman typically presents for genetic counselling because she has a strong family history and is interested in knowing the probability she will develop disease in the future; that is, her absolute risk. Relative risk for a given factor refers to risk compared with either population average risk (sense a), or risk when not having the factor, with all other factors held constant (sense b). Not understanding that these are three distinct concepts can result in failure to correctly appreciate the consequences of studies on clinical genetic testing. Several studies found that the frequencies of mutations in ATM, BRIP1, PALB2 and CHEK2 were many times greater for cases with a strong family history than for controls. To account for the selected case sampling (ascertainment), a statistical model that assumes that the effect of any measured variant multiplies the effect of unmeasured variants was applied. This multiplicative polygenic model in effect estimated the relative risk in the sense b, not sense a, and found it was in the range of 1.7 to 2.4. The authors concluded that the variants are "low penetrance". They failed to note that their model fits predicted that, for some women, absolute risk may be as high as for BRCA2 mutation carriers. This is because the relative risk multiplies polygenic risk, and the latter is predicted by family history. Therefore, mutation testing of these genes for women with a strong family history, especially if it is of early onset, may be as clinically relevant as it is for BRCA1 and BRCA2.

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  • Breast cancer risk in individuals carrying a FANCJ mutation is higher for those with a strong family history.

    “It is worth considering that the breast cancer risk in individuals carrying a FANCJ mutation will be higher for those with a strong family history [55].”

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Authors
Byrnes, G. B., Southey, M. C., & Hopper, J. L.
Affiliations
  • Centre international de recherche sur le cancer (FR)
  • The University of Melbourne (AU)
Corresponding author
Hopper, John L
Venue
Breast Cancer Research
Published
2008-06
Volume
10
Issue
3
Pages
208-208
ISSN
  • 1465-5411 (ISSN-L)
  • 1465-542X
OpenAlex
W2040830737
Cited by
83
References
27
Citations by year
2025: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 1 · 2019: 5 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 5 · 2014: 6 · 2013: 13 · 2012: 1
FWCI
5.70
Type
journal article
Language
en
Open access
Locations
  • Breast Cancer Research (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
Funders
  • Medical Research Council
  • National Health and Medical Research Council (251533, 299955)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
Keywords
ATM, BRIP1, PALB2, CHEK2, absolute risk, relative risk, polygenic risk, mutation testing, genetic counseling, BRCA1, BRCA2, early-onset breast cancer
MeSH terms
Fanconi Anemia Complementation Group N Protein, Alleles, DNA Mutational Analysis, DNA-Binding Proteins, Family Health, Female, Humans, Mutation, Nuclear Proteins, Probability, Risk, Risk Factors, Reproducibility of Results, Protein Serine-Threonine Kinases, Cell Cycle Proteins, Genetic Predisposition to Disease, RNA Helicases, Tumor Suppressor Proteins, Fanconi Anemia Complementation Group Proteins, Ataxia Telangiectasia Mutated Proteins, Checkpoint Kinase 2

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