Spectrum and characterisation of BRCA1 and BRCA2 deleterious mutations in high-risk Czech patients with breast and/or ovarian

Background: The incidence of breast cancer has doubled over the past 20 years in the Czech Republic. Hereditary factors may be a cause of young onset, bilateral breast or ovarian cancer, and familial accumulation of the disease. BRCA1 and BRCA2 mutations account for an important fraction of hereditary breast and ovarian cancer cases. One thousand and ten unrelated high-risk probands with breast and/or ovarian cancer were analysed for the presence of a BRCA1 or BRCA2 gene mutation at the Masaryk Memorial Cancer Institute ( Czech Republic) during 1999-2006. Methods: The complete coding sequences and splice sites of both genes were screened, and the presence of large intragenic rearrangements in BRCA1 was verified. Putative splice-site variants were analysed at the cDNA level for their potential to alter mRNA splicing. Results: In 294 unrelated families ( 29.1% of the 1,010 probands) pathogenic mutations were identified, with 44 different BRCA1 mutations and 41 different BRCA2 mutations being detected in 204 and 90 unrelated families, respectively. In total, three BRCA1 founder mutations ( c. 5266dupC; c. 3700_ 3704del5; p. Cys61Gly) and two BRCA2 founder mutations ( c. 7913_7917del5; c. 8537_8538del2) represent 52% of all detected mutations in Czech high-risk probands. Nine putative splice-site variants were evaluated at the cDNA level. Three splice-site variants in BRCA1 ( c. 302- 3C > G; c. 4185G > A and c. 4675+ 1G > A) and six splice- site variants in BRCA2 ( c. 475G > A; c. 476- 2 > G; c. 7007G > A; c. 8755- 1G > A; c. 9117+ 2T > A and c. 9118- 2A > G) were demonstrated to result in aberrant transcripts and are considered as deleterious mutations. Conclusion: This study represents an evaluation of deleterious genetic variants in the BRCA1 and 2 genes in the Czech population. The classification of several splice- site variants as true pathogenic mutations may prove useful for genetic counselling of families with high risk of breast and ovarian cancer.