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Whole Exome Sequencing Suggests Much of Non-BRCA1/BRCA2 Familial Breast Cancer Is Due to Moderate and Low Penetrance Susceptibility Alleles

Identifieur interne : 004402 ( Main/Exploration ); précédent : 004401; suivant : 004403

Whole Exome Sequencing Suggests Much of Non-BRCA1/BRCA2 Familial Breast Cancer Is Due to Moderate and Low Penetrance Susceptibility Alleles

Auteurs : Francisco Javier Gracia-Aznarez [Espagne] ; Victoria Fernandez [Espagne] ; Guillermo Pita [Espagne] ; Paolo Peterlongo [Italie] ; Orlando Dominguez [Espagne] ; Miguel De La Hoya [Espagne] ; Mercedes Duran [Espagne] ; Ana Osorio [Espagne] ; Leticia Moreno [Espagne] ; Anna Gonzalez-Neira [Espagne] ; Juan Manuel Rosa-Rosa [Espagne] ; Olga Sinilnikova [France] ; Sylvie Mazoyer [France] ; John Hopper [Australie] ; Conchi Lazaro [Espagne] ; Melissa Southey [Australie] ; Fabrice Odefrey [Australie] ; Siranoush Manoukian [Italie] ; Irene Catucci [Italie] ; Trinidad Caldes [Espagne] ; Henry T. Lynch [États-Unis] ; Florentine S. M. Hilbers [Pays-Bas] ; Christi J. Van Asperen [Pays-Bas] ; Hans F. A. Vasen [Pays-Bas] ; David Goldgar [États-Unis] ; Paolo Radice [Italie] ; Peter Devilee [Pays-Bas] ; Javier Benitez [Espagne]

Source :

RBID : PMC:3568132

Abstract

The identification of the two most prevalent susceptibility genes in breast cancer, BRCA1 and BRCA2, was the beginning of a sustained effort to uncover new genes explaining the missing heritability in this disease. Today, additional high, moderate and low penetrance genes have been identified in breast cancer, such as P53, PTEN, STK11, PALB2 or ATM, globally accounting for around 35 percent of the familial cases. In the present study we used massively parallel sequencing to analyze 7 BRCA1/BRCA2 negative families, each having at least 6 affected women with breast cancer (between 6 and 10) diagnosed under the age of 60 across generations. After extensive filtering, Sanger sequencing validation and co-segregation studies, variants were prioritized through either control-population studies, including up to 750 healthy individuals, or case-control assays comprising approximately 5300 samples. As a result, a known moderate susceptibility indel variant (CHEK2 1100delC) and a catalogue of 11 rare variants presenting signs of association with breast cancer were identified. All the affected genes are involved in important cellular mechanisms like DNA repair, cell proliferation and survival or cell cycle regulation. This study highlights the need to investigate the role of rare variants in familial cancer development by means of novel high throughput analysis strategies optimized for genetically heterogeneous scenarios. Even considering the intrinsic limitations of exome resequencing studies, our findings support the hypothesis that the majority of non-BRCA1/BRCA2 breast cancer families might be explained by the action of moderate and/or low penetrance susceptibility alleles.


Url:
DOI: 10.1371/journal.pone.0055681
PubMed: 23409019
PubMed Central: 3568132


Affiliations:


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Le document en format XML

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<name sortKey="Radice, Paolo" sort="Radice, Paolo" uniqKey="Radice P" first="Paolo" last="Radice">Paolo Radice</name>
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</nlm:aff>
<country xml:lang="fr">Italie</country>
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<wicri:regionArea>Department of Human Genetics, Leiden University Medical Center, Leiden</wicri:regionArea>
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<region nuts="2" type="province">Hollande-Méridionale</region>
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</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff21">
<addr-line>Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Pathology, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Benitez, Javier" sort="Benitez, Javier" uniqKey="Benitez J" first="Javier" last="Benitez">Javier Benitez</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">
<addr-line>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff2">
<addr-line>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff22">
<addr-line>Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Biomedical Network on Rare Diseases (CIBERER), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
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<idno type="wicri:Area/Main/Exploration">004402</idno>
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<title xml:lang="en" level="a" type="main">Whole Exome Sequencing Suggests Much of Non-BRCA1/BRCA2 Familial Breast Cancer Is Due to Moderate and Low Penetrance Susceptibility Alleles</title>
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<name sortKey="Gracia Aznarez, Francisco Javier" sort="Gracia Aznarez, Francisco Javier" uniqKey="Gracia Aznarez F" first="Francisco Javier" last="Gracia-Aznarez">Francisco Javier Gracia-Aznarez</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">
<addr-line>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Fernandez, Victoria" sort="Fernandez, Victoria" uniqKey="Fernandez V" first="Victoria" last="Fernandez">Victoria Fernandez</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">
<addr-line>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Pita, Guillermo" sort="Pita, Guillermo" uniqKey="Pita G" first="Guillermo" last="Pita">Guillermo Pita</name>
<affiliation wicri:level="3">
<nlm:aff id="aff2">
<addr-line>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Peterlongo, Paolo" sort="Peterlongo, Paolo" uniqKey="Peterlongo P" first="Paolo" last="Peterlongo">Paolo Peterlongo</name>
<affiliation wicri:level="3">
<nlm:aff id="aff3">
<addr-line>IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff4">
<addr-line>Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Dominguez, Orlando" sort="Dominguez, Orlando" uniqKey="Dominguez O" first="Orlando" last="Dominguez">Orlando Dominguez</name>
<affiliation wicri:level="3">
<nlm:aff id="aff5">
<addr-line>Genomics Unit, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Genomics Unit, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="De La Hoya, Miguel" sort="De La Hoya, Miguel" uniqKey="De La Hoya M" first="Miguel" last="De La Hoya">Miguel De La Hoya</name>
<affiliation wicri:level="3">
<nlm:aff id="aff6">
<addr-line>Laboratorio de Oncología Molecular, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Laboratorio de Oncología Molecular, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Duran, Mercedes" sort="Duran, Mercedes" uniqKey="Duran M" first="Mercedes" last="Duran">Mercedes Duran</name>
<affiliation wicri:level="1">
<nlm:aff id="aff7">
<addr-line>Instituto de Biología y Genética Molecular (IBGM-UVA.CSIC), Valladolid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Instituto de Biología y Genética Molecular (IBGM-UVA.CSIC), Valladolid</wicri:regionArea>
<wicri:noRegion>Valladolid</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Osorio, Ana" sort="Osorio, Ana" uniqKey="Osorio A" first="Ana" last="Osorio">Ana Osorio</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">
<addr-line>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Moreno, Leticia" sort="Moreno, Leticia" uniqKey="Moreno L" first="Leticia" last="Moreno">Leticia Moreno</name>
<affiliation wicri:level="3">
<nlm:aff id="aff2">
<addr-line>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Gonzalez Neira, Anna" sort="Gonzalez Neira, Anna" uniqKey="Gonzalez Neira A" first="Anna" last="Gonzalez-Neira">Anna Gonzalez-Neira</name>
<affiliation wicri:level="3">
<nlm:aff id="aff2">
<addr-line>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Rosa Rosa, Juan Manuel" sort="Rosa Rosa, Juan Manuel" uniqKey="Rosa Rosa J" first="Juan Manuel" last="Rosa-Rosa">Juan Manuel Rosa-Rosa</name>
<affiliation wicri:level="1">
<nlm:aff id="aff8">
<addr-line>Bioinformatics Unit, Sistemas Genómicos, Valencia, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Bioinformatics Unit, Sistemas Genómicos, Valencia</wicri:regionArea>
<wicri:noRegion>Valencia</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Sinilnikova, Olga" sort="Sinilnikova, Olga" uniqKey="Sinilnikova O" first="Olga" last="Sinilnikova">Olga Sinilnikova</name>
<affiliation wicri:level="3">
<nlm:aff id="aff9">
<addr-line>CNRS UMR5286 INSERM U1052, Université Lyon 1, Cancer Research Center of Lyon, Center Léon Bérard, Lyon, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>CNRS UMR5286 INSERM U1052, Université Lyon 1, Cancer Research Center of Lyon, Center Léon Bérard, Lyon</wicri:regionArea>
<placeName>
<region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff10">
<addr-line>Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon, Centre Léon Bérard, Lyon, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon, Centre Léon Bérard, Lyon</wicri:regionArea>
<placeName>
<region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Mazoyer, Sylvie" sort="Mazoyer, Sylvie" uniqKey="Mazoyer S" first="Sylvie" last="Mazoyer">Sylvie Mazoyer</name>
<affiliation wicri:level="3">
<nlm:aff id="aff9">
<addr-line>CNRS UMR5286 INSERM U1052, Université Lyon 1, Cancer Research Center of Lyon, Center Léon Bérard, Lyon, France</addr-line>
</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>CNRS UMR5286 INSERM U1052, Université Lyon 1, Cancer Research Center of Lyon, Center Léon Bérard, Lyon</wicri:regionArea>
<placeName>
<region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Hopper, John" sort="Hopper, John" uniqKey="Hopper J" first="John" last="Hopper">John Hopper</name>
<affiliation wicri:level="4">
<nlm:aff id="aff11">
<addr-line>Centre for Molecular, Environmental, Genetic and Analytical Epidemiology, School of Population Health, The University of Melbourne, Victoria, Australia</addr-line>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Centre for Molecular, Environmental, Genetic and Analytical Epidemiology, School of Population Health, The University of Melbourne, Victoria</wicri:regionArea>
<orgName type="university">Université de Melbourne</orgName>
<placeName>
<settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lazaro, Conchi" sort="Lazaro, Conchi" uniqKey="Lazaro C" first="Conchi" last="Lazaro">Conchi Lazaro</name>
<affiliation wicri:level="3">
<nlm:aff id="aff12">
<addr-line>Molecular Diagnostic Unit, Hereditary Cancer Program, Institut Català d’Oncologia-IDIBELL, Barcelona, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Molecular Diagnostic Unit, Hereditary Cancer Program, Institut Català d’Oncologia-IDIBELL, Barcelona</wicri:regionArea>
<placeName>
<settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Southey, Melissa" sort="Southey, Melissa" uniqKey="Southey M" first="Melissa" last="Southey">Melissa Southey</name>
<affiliation wicri:level="4">
<nlm:aff id="aff13">
<addr-line>Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Victoria, Australia</addr-line>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Victoria</wicri:regionArea>
<orgName type="university">Université de Melbourne</orgName>
<placeName>
<settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Odefrey, Fabrice" sort="Odefrey, Fabrice" uniqKey="Odefrey F" first="Fabrice" last="Odefrey">Fabrice Odefrey</name>
<affiliation wicri:level="4">
<nlm:aff id="aff13">
<addr-line>Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Victoria, Australia</addr-line>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Victoria</wicri:regionArea>
<orgName type="university">Université de Melbourne</orgName>
<placeName>
<settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Manoukian, Siranoush" sort="Manoukian, Siranoush" uniqKey="Manoukian S" first="Siranoush" last="Manoukian">Siranoush Manoukian</name>
<affiliation wicri:level="3">
<nlm:aff id="aff14">
<addr-line>Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Catucci, Irene" sort="Catucci, Irene" uniqKey="Catucci I" first="Irene" last="Catucci">Irene Catucci</name>
<affiliation wicri:level="3">
<nlm:aff id="aff3">
<addr-line>IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff4">
<addr-line>Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Caldes, Trinidad" sort="Caldes, Trinidad" uniqKey="Caldes T" first="Trinidad" last="Caldes">Trinidad Caldes</name>
<affiliation wicri:level="3">
<nlm:aff id="aff6">
<addr-line>Laboratorio de Oncología Molecular, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Laboratorio de Oncología Molecular, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lynch, Henry T" sort="Lynch, Henry T" uniqKey="Lynch H" first="Henry T." last="Lynch">Henry T. Lynch</name>
<affiliation wicri:level="2">
<nlm:aff id="aff15">
<addr-line>Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, Nebraska, United States of America</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, Nebraska</wicri:regionArea>
<placeName>
<region type="state">Nebraska</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Hilbers, Florentine S M" sort="Hilbers, Florentine S M" uniqKey="Hilbers F" first="Florentine S. M." last="Hilbers">Florentine S. M. Hilbers</name>
<affiliation wicri:level="3">
<nlm:aff id="aff16">
<addr-line>Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Human Genetics, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Van Asperen, Christi J" sort="Van Asperen, Christi J" uniqKey="Van Asperen C" first="Christi J." last="Van Asperen">Christi J. Van Asperen</name>
<affiliation wicri:level="3">
<nlm:aff id="aff17">
<addr-line>Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Clinical Genetics, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Vasen, Hans F A" sort="Vasen, Hans F A" uniqKey="Vasen H" first="Hans F. A." last="Vasen">Hans F. A. Vasen</name>
<affiliation wicri:level="3">
<nlm:aff id="aff18">
<addr-line>Foundation for the Detection of Hereditary Tumors, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Foundation for the Detection of Hereditary Tumors, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff19">
<addr-line>Department of Gastroenterology, Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Gastroenterology, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Goldgar, David" sort="Goldgar, David" uniqKey="Goldgar D" first="David" last="Goldgar">David Goldgar</name>
<affiliation wicri:level="2">
<nlm:aff id="aff20">
<addr-line>Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America</addr-line>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah</wicri:regionArea>
<placeName>
<region type="state">Utah</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Radice, Paolo" sort="Radice, Paolo" uniqKey="Radice P" first="Paolo" last="Radice">Paolo Radice</name>
<affiliation wicri:level="3">
<nlm:aff id="aff3">
<addr-line>IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff4">
<addr-line>Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy</addr-line>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea>
<placeName>
<settlement type="city">Milan</settlement>
<region nuts="2">Lombardie</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Devilee, Peter" sort="Devilee, Peter" uniqKey="Devilee P" first="Peter" last="Devilee">Peter Devilee</name>
<affiliation wicri:level="3">
<nlm:aff id="aff16">
<addr-line>Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Human Genetics, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff21">
<addr-line>Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands</addr-line>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Pathology, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Benitez, Javier" sort="Benitez, Javier" uniqKey="Benitez J" first="Javier" last="Benitez">Javier Benitez</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">
<addr-line>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genetics Group, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff2">
<addr-line>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Human Genotyping Unit –CEGEN, Spanish National Cancer Centre (CNIO), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff22">
<addr-line>Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain</addr-line>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Biomedical Network on Rare Diseases (CIBERER), Madrid</wicri:regionArea>
<placeName>
<settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j">PLoS ONE</title>
<idno type="eISSN">1932-6203</idno>
<imprint>
<date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>The identification of the two most prevalent susceptibility genes in breast cancer,
<italic>BRCA1</italic>
and
<italic>BRCA2</italic>
, was the beginning of a sustained effort to uncover new genes explaining the missing heritability in this disease. Today, additional high, moderate and low penetrance genes have been identified in breast cancer, such as
<italic>P53</italic>
,
<italic>PTEN</italic>
,
<italic>STK11</italic>
,
<italic>PALB2</italic>
or
<italic>ATM</italic>
, globally accounting for around 35 percent of the familial cases. In the present study we used massively parallel sequencing to analyze 7
<italic>BRCA1</italic>
/
<italic>BRCA2</italic>
negative families, each having at least 6 affected women with breast cancer (between 6 and 10) diagnosed under the age of 60 across generations. After extensive filtering, Sanger sequencing validation and co-segregation studies, variants were prioritized through either control-population studies, including up to 750 healthy individuals, or case-control assays comprising approximately 5300 samples. As a result, a known moderate susceptibility indel variant (
<italic>CHEK2</italic>
1100delC) and a catalogue of 11 rare variants presenting signs of association with breast cancer were identified. All the affected genes are involved in important cellular mechanisms like DNA repair, cell proliferation and survival or cell cycle regulation. This study highlights the need to investigate the role of rare variants in familial cancer development by means of novel high throughput analysis strategies optimized for genetically heterogeneous scenarios. Even considering the intrinsic limitations of exome resequencing studies, our findings support the hypothesis that the majority of non-
<italic>BRCA1</italic>
/
<italic>BRCA2</italic>
breast cancer families might be explained by the action of moderate and/or low penetrance susceptibility alleles.</p>
</div>
</front>
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<name sortKey="Thompson, Er" uniqKey="Thompson E">ER Thompson</name>
</author>
<author>
<name sortKey="Doyle, Ma" uniqKey="Doyle M">MA Doyle</name>
</author>
<author>
<name sortKey="Ryland, Gl" uniqKey="Ryland G">GL Ryland</name>
</author>
<author>
<name sortKey="Rowley, Sm" uniqKey="Rowley S">SM Rowley</name>
</author>
<author>
<name sortKey="Choong, Dy" uniqKey="Choong D">DY Choong</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Snape, K" uniqKey="Snape K">K Snape</name>
</author>
<author>
<name sortKey="Hanks, S" uniqKey="Hanks S">S Hanks</name>
</author>
<author>
<name sortKey="Ruark, E" uniqKey="Ruark E">E Ruark</name>
</author>
<author>
<name sortKey="Barros Nunez, P" uniqKey="Barros Nunez P">P Barros-Nunez</name>
</author>
<author>
<name sortKey="Elliott, A" uniqKey="Elliott A">A Elliott</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Chahrour, Mh" uniqKey="Chahrour M">MH Chahrour</name>
</author>
<author>
<name sortKey="Yu, Tw" uniqKey="Yu T">TW Yu</name>
</author>
<author>
<name sortKey="Lim, Et" uniqKey="Lim E">ET Lim</name>
</author>
<author>
<name sortKey="Ataman, B" uniqKey="Ataman B">B Ataman</name>
</author>
<author>
<name sortKey="Coulter, Me" uniqKey="Coulter M">ME Coulter</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Antoniou, Ac" uniqKey="Antoniou A">AC Antoniou</name>
</author>
<author>
<name sortKey="Easton, Df" uniqKey="Easton D">DF Easton</name>
</author>
</analytic>
</biblStruct>
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<analytic>
<author>
<name sortKey="Fletcher, O" uniqKey="Fletcher O">O Fletcher</name>
</author>
<author>
<name sortKey="Houlston, Rs" uniqKey="Houlston R">RS Houlston</name>
</author>
</analytic>
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<name sortKey="Rosa Rosa, Jm" uniqKey="Rosa Rosa J">JM Rosa-Rosa</name>
</author>
<author>
<name sortKey="Gracia Aznarez, Fj" uniqKey="Gracia Aznarez F">FJ Gracia-Aznarez</name>
</author>
<author>
<name sortKey="Hodges, E" uniqKey="Hodges E">E Hodges</name>
</author>
<author>
<name sortKey="Pita, G" uniqKey="Pita G">G Pita</name>
</author>
<author>
<name sortKey="Rooks, M" uniqKey="Rooks M">M Rooks</name>
</author>
</analytic>
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<country>
<li>Australie</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>États-Unis</li>
</country>
<region>
<li>Auvergne-Rhône-Alpes</li>
<li>Catalogne</li>
<li>Communauté de Madrid</li>
<li>Hollande-Méridionale</li>
<li>Lombardie</li>
<li>Nebraska</li>
<li>Rhône-Alpes</li>
<li>Utah</li>
<li>Victoria (État)</li>
</region>
<settlement>
<li>Barcelone</li>
<li>Leyde</li>
<li>Lyon</li>
<li>Madrid</li>
<li>Melbourne</li>
<li>Milan</li>
</settlement>
<orgName>
<li>Université de Melbourne</li>
</orgName>
</list>
<tree>
<country name="Espagne">
<region name="Communauté de Madrid">
<name sortKey="Gracia Aznarez, Francisco Javier" sort="Gracia Aznarez, Francisco Javier" uniqKey="Gracia Aznarez F" first="Francisco Javier" last="Gracia-Aznarez">Francisco Javier Gracia-Aznarez</name>
</region>
<name sortKey="Benitez, Javier" sort="Benitez, Javier" uniqKey="Benitez J" first="Javier" last="Benitez">Javier Benitez</name>
<name sortKey="Benitez, Javier" sort="Benitez, Javier" uniqKey="Benitez J" first="Javier" last="Benitez">Javier Benitez</name>
<name sortKey="Benitez, Javier" sort="Benitez, Javier" uniqKey="Benitez J" first="Javier" last="Benitez">Javier Benitez</name>
<name sortKey="Caldes, Trinidad" sort="Caldes, Trinidad" uniqKey="Caldes T" first="Trinidad" last="Caldes">Trinidad Caldes</name>
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<name sortKey="Dominguez, Orlando" sort="Dominguez, Orlando" uniqKey="Dominguez O" first="Orlando" last="Dominguez">Orlando Dominguez</name>
<name sortKey="Duran, Mercedes" sort="Duran, Mercedes" uniqKey="Duran M" first="Mercedes" last="Duran">Mercedes Duran</name>
<name sortKey="Fernandez, Victoria" sort="Fernandez, Victoria" uniqKey="Fernandez V" first="Victoria" last="Fernandez">Victoria Fernandez</name>
<name sortKey="Gonzalez Neira, Anna" sort="Gonzalez Neira, Anna" uniqKey="Gonzalez Neira A" first="Anna" last="Gonzalez-Neira">Anna Gonzalez-Neira</name>
<name sortKey="Lazaro, Conchi" sort="Lazaro, Conchi" uniqKey="Lazaro C" first="Conchi" last="Lazaro">Conchi Lazaro</name>
<name sortKey="Moreno, Leticia" sort="Moreno, Leticia" uniqKey="Moreno L" first="Leticia" last="Moreno">Leticia Moreno</name>
<name sortKey="Osorio, Ana" sort="Osorio, Ana" uniqKey="Osorio A" first="Ana" last="Osorio">Ana Osorio</name>
<name sortKey="Pita, Guillermo" sort="Pita, Guillermo" uniqKey="Pita G" first="Guillermo" last="Pita">Guillermo Pita</name>
<name sortKey="Rosa Rosa, Juan Manuel" sort="Rosa Rosa, Juan Manuel" uniqKey="Rosa Rosa J" first="Juan Manuel" last="Rosa-Rosa">Juan Manuel Rosa-Rosa</name>
</country>
<country name="Italie">
<region name="Lombardie">
<name sortKey="Peterlongo, Paolo" sort="Peterlongo, Paolo" uniqKey="Peterlongo P" first="Paolo" last="Peterlongo">Paolo Peterlongo</name>
</region>
<name sortKey="Catucci, Irene" sort="Catucci, Irene" uniqKey="Catucci I" first="Irene" last="Catucci">Irene Catucci</name>
<name sortKey="Catucci, Irene" sort="Catucci, Irene" uniqKey="Catucci I" first="Irene" last="Catucci">Irene Catucci</name>
<name sortKey="Manoukian, Siranoush" sort="Manoukian, Siranoush" uniqKey="Manoukian S" first="Siranoush" last="Manoukian">Siranoush Manoukian</name>
<name sortKey="Peterlongo, Paolo" sort="Peterlongo, Paolo" uniqKey="Peterlongo P" first="Paolo" last="Peterlongo">Paolo Peterlongo</name>
<name sortKey="Radice, Paolo" sort="Radice, Paolo" uniqKey="Radice P" first="Paolo" last="Radice">Paolo Radice</name>
<name sortKey="Radice, Paolo" sort="Radice, Paolo" uniqKey="Radice P" first="Paolo" last="Radice">Paolo Radice</name>
</country>
<country name="France">
<region name="Auvergne-Rhône-Alpes">
<name sortKey="Sinilnikova, Olga" sort="Sinilnikova, Olga" uniqKey="Sinilnikova O" first="Olga" last="Sinilnikova">Olga Sinilnikova</name>
</region>
<name sortKey="Mazoyer, Sylvie" sort="Mazoyer, Sylvie" uniqKey="Mazoyer S" first="Sylvie" last="Mazoyer">Sylvie Mazoyer</name>
<name sortKey="Sinilnikova, Olga" sort="Sinilnikova, Olga" uniqKey="Sinilnikova O" first="Olga" last="Sinilnikova">Olga Sinilnikova</name>
</country>
<country name="Australie">
<region name="Victoria (État)">
<name sortKey="Hopper, John" sort="Hopper, John" uniqKey="Hopper J" first="John" last="Hopper">John Hopper</name>
</region>
<name sortKey="Odefrey, Fabrice" sort="Odefrey, Fabrice" uniqKey="Odefrey F" first="Fabrice" last="Odefrey">Fabrice Odefrey</name>
<name sortKey="Southey, Melissa" sort="Southey, Melissa" uniqKey="Southey M" first="Melissa" last="Southey">Melissa Southey</name>
</country>
<country name="États-Unis">
<region name="Nebraska">
<name sortKey="Lynch, Henry T" sort="Lynch, Henry T" uniqKey="Lynch H" first="Henry T." last="Lynch">Henry T. Lynch</name>
</region>
<name sortKey="Goldgar, David" sort="Goldgar, David" uniqKey="Goldgar D" first="David" last="Goldgar">David Goldgar</name>
</country>
<country name="Pays-Bas">
<region name="Hollande-Méridionale">
<name sortKey="Hilbers, Florentine S M" sort="Hilbers, Florentine S M" uniqKey="Hilbers F" first="Florentine S. M." last="Hilbers">Florentine S. M. Hilbers</name>
</region>
<name sortKey="Devilee, Peter" sort="Devilee, Peter" uniqKey="Devilee P" first="Peter" last="Devilee">Peter Devilee</name>
<name sortKey="Devilee, Peter" sort="Devilee, Peter" uniqKey="Devilee P" first="Peter" last="Devilee">Peter Devilee</name>
<name sortKey="Van Asperen, Christi J" sort="Van Asperen, Christi J" uniqKey="Van Asperen C" first="Christi J." last="Van Asperen">Christi J. Van Asperen</name>
<name sortKey="Vasen, Hans F A" sort="Vasen, Hans F A" uniqKey="Vasen H" first="Hans F. A." last="Vasen">Hans F. A. Vasen</name>
<name sortKey="Vasen, Hans F A" sort="Vasen, Hans F A" uniqKey="Vasen H" first="Hans F. A." last="Vasen">Hans F. A. Vasen</name>
</country>
</tree>
</affiliations>
</record>

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