Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer

Pathogenic/likely pathogenic germline variants in the BRCA1 and BRCA2 genes are associated with an increased risk of developing cancer, particularly breast and/or ovarian tumors. The identification and correct classification of these variants is crucial to find individuals with an increased risk of...

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Main Authors: Alice Faversani, Debora Manuelli, Davide Barteselli, Giulia Melloni, Carlo Santaniello, Luigi Corsaro, Davide Sacco, Davide Clerici, Laura Gargiulo, Fulvio Ferrara, Lucy Costantino
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1497531/full
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author Alice Faversani
Debora Manuelli
Davide Barteselli
Giulia Melloni
Carlo Santaniello
Luigi Corsaro
Luigi Corsaro
Davide Sacco
Davide Sacco
Davide Clerici
Laura Gargiulo
Fulvio Ferrara
Lucy Costantino
author_facet Alice Faversani
Debora Manuelli
Davide Barteselli
Giulia Melloni
Carlo Santaniello
Luigi Corsaro
Luigi Corsaro
Davide Sacco
Davide Sacco
Davide Clerici
Laura Gargiulo
Fulvio Ferrara
Lucy Costantino
author_sort Alice Faversani
collection DOAJ
description Pathogenic/likely pathogenic germline variants in the BRCA1 and BRCA2 genes are associated with an increased risk of developing cancer, particularly breast and/or ovarian tumors. The identification and correct classification of these variants is crucial to find individuals with an increased risk of cancer and to support physicians in their clinical and therapeutic decisions. In addition, the status of BRCA1 and BRCA2 variants is important for appropriate management of patients’ family members. Here, we describe the case of a woman who developed triple-negative breast cancer at the age of 49 years. NGS analysis of BRCA1 and BRCA2 genes revealed the presence of a new partial BRCA1 exon 10 duplication of 2.012 bp. The identified duplication comprises 395 nucleotides from the final portion of intron 9 and 1617 nucleotides from the beginning of exon 10. Using specific primers, we were able to identify the breakpoint at the DNA level and characterize the alteration as a tandem duplication leading to the formation of a premature stop codon after 10 residues. RNA analysis allowed to confirm the production of an altered mRNA showing the duplicated sequence. In this way, we were able to assign a clinical significance to the new alteration and classify it as a pathogenic variant. Although new ClinGen ENIGMA guidelines have been produced to provide tools for the accurate interpretation of variants in the BRCA1 and BRCA2 genes, defining the clinical significance of copy number variants, particularly duplications, remains a challenging goal that requires complex approaches to accurately determine the role of such variants. Other investigations, such as the detection of breakpoints by RNA analysis, are often essential to classify the identified alteration. Our study suggests that RNA transcript analysis is an ideal methodology to support the accurate classification of variants and clarify their effects.
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spelling doaj-art-5e7077acb77f4d23b0014e2d7287c1fe2025-02-06T05:21:48ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-02-011510.3389/fonc.2025.14975311497531Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancerAlice Faversani0Debora Manuelli1Davide Barteselli2Giulia Melloni3Carlo Santaniello4Luigi Corsaro5Luigi Corsaro6Davide Sacco7Davide Sacco8Davide Clerici9Laura Gargiulo10Fulvio Ferrara11Lucy Costantino12Laboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyDepartment of Brain and Behavioral Science, Università Degli Studi di Pavia, Pavia, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyDepartment of Brain and Behavioral Science, Università Degli Studi di Pavia, Pavia, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyIntegrated Laboratory Medicine Services, Centro Diagnostico Italiano, Milan, ItalyLaboratory of Medical Genetics, Centro Diagnostico Italiano, Milan, ItalyPathogenic/likely pathogenic germline variants in the BRCA1 and BRCA2 genes are associated with an increased risk of developing cancer, particularly breast and/or ovarian tumors. The identification and correct classification of these variants is crucial to find individuals with an increased risk of cancer and to support physicians in their clinical and therapeutic decisions. In addition, the status of BRCA1 and BRCA2 variants is important for appropriate management of patients’ family members. Here, we describe the case of a woman who developed triple-negative breast cancer at the age of 49 years. NGS analysis of BRCA1 and BRCA2 genes revealed the presence of a new partial BRCA1 exon 10 duplication of 2.012 bp. The identified duplication comprises 395 nucleotides from the final portion of intron 9 and 1617 nucleotides from the beginning of exon 10. Using specific primers, we were able to identify the breakpoint at the DNA level and characterize the alteration as a tandem duplication leading to the formation of a premature stop codon after 10 residues. RNA analysis allowed to confirm the production of an altered mRNA showing the duplicated sequence. In this way, we were able to assign a clinical significance to the new alteration and classify it as a pathogenic variant. Although new ClinGen ENIGMA guidelines have been produced to provide tools for the accurate interpretation of variants in the BRCA1 and BRCA2 genes, defining the clinical significance of copy number variants, particularly duplications, remains a challenging goal that requires complex approaches to accurately determine the role of such variants. Other investigations, such as the detection of breakpoints by RNA analysis, are often essential to classify the identified alteration. Our study suggests that RNA transcript analysis is an ideal methodology to support the accurate classification of variants and clarify their effects.https://www.frontiersin.org/articles/10.3389/fonc.2025.1497531/fullHBOCbreast cancerBRCA1variants of uncertain clinical significancecase report
spellingShingle Alice Faversani
Debora Manuelli
Davide Barteselli
Giulia Melloni
Carlo Santaniello
Luigi Corsaro
Luigi Corsaro
Davide Sacco
Davide Sacco
Davide Clerici
Laura Gargiulo
Fulvio Ferrara
Lucy Costantino
Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer
Frontiers in Oncology
HBOC
breast cancer
BRCA1
variants of uncertain clinical significance
case report
title Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer
title_full Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer
title_fullStr Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer
title_full_unstemmed Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer
title_short Case report: Deciphering the clinical significance of a novel partial BRCA1 exon 10 duplication in a patient with triple-negative breast cancer
title_sort case report deciphering the clinical significance of a novel partial brca1 exon 10 duplication in a patient with triple negative breast cancer
topic HBOC
breast cancer
BRCA1
variants of uncertain clinical significance
case report
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1497531/full
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