IntroductionBreast cancer is the most common cancer among women worldwide and causes significant morbidity and mortality (1). According to the 2009 statistics of the Turkish Statistical Institute (TUIK), the leading cancer and the seventh-most-frequent cancer among women were breast and ovarian carcinoma, respectively. Among Turkish women, the incidence of breast cancer and ovarian carcinoma is 23% and 3.9%, respectively. Therefore, breast and ovarian carcinoma are important health problems for Turkish society. Furthermore, consanguineous marriages, especially among first cousins, are quite common in Turkey. This may lead to higher cancer risks, especially in families with cancer histories. It is very important to detect hereditary cancer risk using genetic testing for individuals in high-risk families as well as genetic testing, if applied correctly. Hence it is very important to determine the limits and content of genetic tests.Several factors increase the risk of breast cancer such as family history, reproductive history, diet, hormone use, radiation exposure, obesity, sedentary lifestyle, lack of breast-feeding, and exogenous hormone replacement therapy (1). Among these, a family history with breast and ovarian cancer in several generations is present in about 15-20% of all cases (2). Germline mutations of two major tumor suppressor genes, BRCA1 and BRCA2, are inherited in an autosomal dominant pattern and have links to breast and ovarian cancer (3). These two mutated genes increase the risk of breast cancer by 87% and 44% for ovarian cancer over the lifetime of female patients (4, 5). BRCA1 and BRCA2 participate in cellular functions such as cell growth, cell division, and genetic instability. Eur J Breast Health 2018; 14: 93-99 DOI: 10.5152/ejbh.2017.3799 93 ABSTRACT Objective: The current rearrangement ratio of BRCA1 and BRCA2 genes is not known in the Turkish population. Rearrangements are not routinely investigated in many Turkish laboratories. This creates problems and contradictions between clinics. Therefore, the aim of this study was to evaluate the distribution and frequency of rearrangements in BRCA1 and BRCA2 genes in high-risk families and to clarify the limits of BRCA1 and BRCA2 testing in Turkey.
Frequency of Rearrangements Versus
Materials and Methods:The study included 1809 patients at high risk of breast cancer or ovarian cancer. All patients were investigated for both small indels and rearrangements of BRCA genes using DNA sequencing and multiplex ligation-dependent probe amplification (MLPA) analysis.
Results:The overall frequency of rearrangements was 2% (25/1262). The frequency of rearrangements was 1.7% (18/1086) and 4% (9/206) in patients with breast cancer and ovarian cancer, respectively. The frequency of rearrangements was 3.7% (8/215) in patients with triple-negative breast cancer. The rearrangement rate was 7.7% (2/26) in patients with both breast and ovarian cancer.
Conclusions:Rearrangements were found with high rates and were strongly associated with bilateral and triple-...