Germline pathogenic variants in cancer predisposition genes among women with invasive lobular cancer of breast.

Authors

Siddhartha Yadav

Siddhartha Yadav

Mayo Clinic, Rochester, MN

Siddhartha Yadav , Chunling Hu , Susan M. Domchek , Jeffrey N. Weitzel , David Goldgar , Peter Kraft , Katherine L. Nathanson , Rachid Karam , Elizabeth Chao , Amal Yussuf , Tina Pesaran , Jill S. Dolinsky , Steven Hart , Holly LaDuca , Eric Polley , Fergus Couch

Organizations

Mayo Clinic, Rochester, MN, University of Pennsylvania, Philadelphia, PA, Oncogenetics for Precision Prevention, and Latin American School of Oncology, Sierra Madre, CA, University of Utah, Salt Lake City, UT, Harvard School of Public Health, Boston, MA, Ambry Genetics Corp, Aliso Viejo, CA, UC Irvine, Irvine, CA, Ambry Genetics, Aliso Viejo, CA, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: The prevalence of germline pathogenic variants (PVs) in cancer predisposition genes among women with invasive lobular breast cancer (ILC) and the risk of ILC in PV carriers is not well-defined. Methods: The study included 2,999 women with ILC and 32,544 unaffected controls from a population-based cohort; 3,796 women with ILC and 20,323 women with invasive ductal carcinoma (IDC) undergoing clinical multigene panel testing (clinical cohort); and 125,748 exome sequences from unrelated women without a cancer diagnosis in the gnomAD 3.0 dataset. Frequencies of germline PVs in breast cancer predisposition genes (ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, and TP53) were compared between women with ILC and unaffected controls in both cohorts and between women with ILC and IDC in the clinical cohort. Results: The frequency of PVs in breast cancer predisposition genes among women with ILC was 6.5% in the clinical cohort and 5.2% in the population-based cohort. In case-control analyses, CDH1 and BRCA2 PVs were associated with high risks of ILC (Odds ratio (OR) > 4), and CHEK2, ATM and PALB2 PVs were associated with moderate (OR = 2-4) risks. BRCA1 PVs and CHEK2 p.Ile157Thr were not associated with clinically relevant risks (OR < 2) of ILC. PV frequencies in these genes in ILC and IDC were similar except for PV frequencies in BRCA1 and CDH1. Conclusions: The study establishes that PVs in ATM, BRCA2, CDH1, CHEK2 and PALB2 are associated with an increased risk of ILC, whereas BRCA1 PVs are not. The similar overall PV frequencies for ILC and IDC suggest that cancer histology should not influence the decision to proceed with genetic testing. While, multigene panel testing may be appropriate for women with ILC, CDH1 should be specifically discussed in the context of low prevalence and attendant gastric cancer risk.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Prevention, Risk Reduction, and Hereditary Cancer

Track

Prevention, Risk Reduction, and Genetics

Sub Track

Germline Genetic Testing

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 10581)

DOI

10.1200/JCO.2021.39.15_suppl.10581

Abstract #

10581

Poster Bd #

Online Only

Abstract Disclosures

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