The BRCA1 and BRCA2 gene products are thought to play important roles in the processing of DNA damage. To assess whether heterozygous mutations in these genes are associated with cellular radiosensitivity, we performed an in vitro radiation clonogenic survival assay on dermal fibroblasts obtained from 8 sequence-proven BRCA heterozygotes (6 BRCA1, 2 BRCA2). These data were compared to results obtained from a previous set of 17 prospectively studied cancer patients who had a negligible risk for a BRCA mutation. In addition, results from radiation-induced chromatid break assay performed on lymphocytes obtained from 9 BRCA heterozygotes (8 BRCA1, 1 BRCA2) were compared to results from a control group of 18 women with no cancer history. Results from both assays suggested that cells containing a heterozygous mutation in BRCA1 or BRCA2 were more radiosensitive than controls. For the fibroblast studies, the mean surviving fraction at 2 Gy (SF2) for carriers was 0.279 vs.
Key words: radiation; chromatid breaks; fibroblasts; clonogenic survivalThe carcinogenic risks of mammography and ionizing radiation treatments for individuals with a BRCA1 or BRCA2 germline mutation have not been determined. In vivo and in vitro studies suggest that homozygous mutations in either BRCA1 or BRCA2 result in a deficiency in processing of DNA damage repair and radiosensitivity. 1,2 Whether individuals heterozygous for a BRCA1 or BRCA2 mutation exhibit impaired recognition and processing of DNA damage is unknown. This is a relevant question for the management of individuals with a germline BRCA mutation, in that a deficiency in cellular DNA damage repair could increase the risk of a normal tissue injury following ionizing radiation or increase the risk of radiation-induced breast carcinogenesis. Furthermore, it may also impact the sensitivity of nonbreast and non-ovarian tissues to mutagenesis and carcinogenesis. We have experience with 2 in vitro assays that study cellular radiosensitivity. The radiation-induced chromatid break assay has been shown to correlate with the risk of developing lung cancer, brain tumors and most recently with bilateral breast cancer. 3,4,5 We have also previously shown that fibroblast clonogenic cell survival curves reflect intrinsic cellular radiosensitivity and correlate with the probability of normal tissue injury following ionizing radiation treatment. 6,7 Our study describes the results of in vitro radiosensitivity assays performed on fibroblasts and lymphocytes obtained from individuals with a sequence-proven mutation in either BRCA1 or BRCA2. These preliminary data suggest that a germline mutation in BRCA1 or BRCA2 is associated with increased radiosensitivity compatible with haplotype insufficiency.
MATERIAL AND METHODS
Study populationOur study was conducted under protocols approved by the Institutional Review Board of the University of Texas M. D. Anderson Cancer Center, Houston, TX. All study participants provided informed consent and participated voluntarily. A total of 7 individuals with sequence-p...