Summary A restriction site-generating polymerase chain reaction (RG-PCR) assay was developed to detect the BRCAl 5382insC mutation that has been reported in multiple, apparently unrelated breast/ovarian carcinoma families. The assay has been used to screen tumour DNA from 250 breast cancer patients (aged 19-86 years) and from 80 ovarian cancer patients (aged 25-90 years) in a local population of patients with no known family history. Altogether, 0/80 (0%) ovarian and 1/250 (0.4%) breast tumour DNAs were found to have the 5382insC mutation. The sole positive case was a 26-year-old woman (BC1 85) with no known family history. One of the reasons for carrying out this analysis was that the 5382insC mutation had previously been shown to segregate with the disease in a very large Scottish 'West Lothian' kindred having breast/ovarian carcinoma. To investigate whether this apparently isolated case and the known family might be related, haplotypes for the markers D17S855, D17S1322, D17S1323 and D17S1327 were analysed. The mutant haplotype in the large kindred was identical to that reported in all other 5382insC mutation families for all markers with the exception of D17S1327. This implies that there has been a recombination event at the telomeric end of common ancestral haplotype in this family. Since the isolated case we identified carries the Icomplete' common haplotype, it is unlikely that she is closely related to the West Lothian family.Keywords: BRCA1; 5382insC; breast cancer; polymerase chain reaction The BRCAJ gene was first mapped to chromosome 17q by linkage analysis (Hall et al, 1990;Narod et al, 1991) and subsequently by positional cloning Futreal et al, 1994). The gene contains 22 coding exons distributed over more than 100 kb and codes for a protein of 1863 amino acids. Loss-of-function mutations in the BRCAJ gene on 17q21 are responsible for about half of all familial early onset female breast cancers. Furthermore, 80-90% of families in which two or more cases of early onset breast cancer and two or more cases of ovarian cancer occur carry BRCAJ mutations (Easton et al, 1993; Narod et al, 1995). Such genetic predispositions are thought to be responsible for between 5% and 10% of all females with breast cancer (Newman et al, 1988;Claus et al, 1991).The BRCAJ 5382insC mutation has been widely reported (Castilla et al, 1994;Friedman et al, 1994;Gayther et al, 1995), including a study of four apparently unrelated Canadian families (Simard et al, 1994). Each of these families shared a common haplotype around the BRCAJ gene and are thus thought to be of the same ancestral mutation. This mutation was recently identified in a large Scottish 'West Lothian' family with familial breast/ ovarian carcinoma (manuscript in preparation), suggesting that Scottish families may share the same ancestral chromosome seen in the aforementioned Canadian families.The present study was carried out in order to develop a robust restriction site-generating polymerase chain reaction (RG-PCR)-based assay for 5382insC to enable us to det...