The integrity of the carboxyl-terminal BRCT repeat region is critical for BRCA1 tumor suppressor function; however, the molecular details of how a number of clinically derived BRCT missense mutations affect BRCA1 function remain largely unknown. Here we assess the structural response of the BRCT tandem repeat domain to a well characterized, cancer-associated single amino acid substitution, Met-1775 3 Arg-1775. The structure of BRCT-M1775R reveals that the mutated side chain is extruded from the protein hydrophobic core, thereby altering the protein surface. Charge-charge repulsion, rearrangement of the hydrophobic core, and disruption of the native hydrogen bonding network at the interface between the two BRCT repeats contribute to the conformational instability of BRCT-M1775R. Destabilization and global unfolding of the mutated BRCT domain at physiological temperatures explain the pleiotropic molecular and genetic defects associated with the BRCA1-M1775R protein.Germ line mutations within the breast and ovarian cancer susceptibility gene BRCA1 predispose carriers to early onset breast and ovarian cancer, and it is estimated that ϳ5-10% of all breast cancers are caused by inheritance of dominant disease genes (1). Various lines of evidence suggest that the BRCA1 protein product is involved in the regulation of multiple nuclear functions including transcription, recombination, DNA repair, and checkpoint control (for reviews, see Refs. 2-4). BRCA1 is an 1863-amino acid nuclear phosphoprotein that includes an amino-terminal RING finger domain and two tandem carboxyl-terminal repeats, termed the BRCT domain. The importance of the conserved RING and BRCT domains to the tumor suppressor function of BRCA1 is demonstrated by the fact that the majority of known cancer-causing BRCA1 mutations localize to these domains (5-9).The extreme carboxyl-terminal region of BRCA1 contains two ϳ90 -100 amino acid sequence repeats called BRCT 1 (BRCA1 carboxyl-terminal) repeats that are the prototypical members of a protein fold superfamily that includes many proteins associated with DNA repair (10 -12). The recently determined x-ray crystal structures of the human (13) and rat (14) BRCA1 BRCT repeats provide a framework for the interpretation of BRCT mutations identified in patients from breast cancer screening programs. The two structurally similar BRCT repeats resemble the structures of the isolated BRCT domains from XRCC1 (15) and DNA ligase III (16) and are composed of a central four-stranded, parallel -sheet flanked by a single ␣-helix on one side (␣2), with a pair of ␣-helices (␣1 and ␣3) and a short 3 10 -helix on the opposite side. The two repeats are connected by a relatively flexible linker and pack together in a specific, head-to-tail manner that is conserved not only between human and rat BRCA1 but also in the BRCT domain of the p53-interacting protein, 53BP1 (13,14). Several cancer-associated BRCT missense mutations (1, 6) have been characterized in functional detail. Two extensively studied variants, A1708E and M1775R,...