Abstract 999: Spectrum of germline BRCA1/2 gene mutations in Nigerian breast cancer patients

Abstract

Breast cancer (BC) is the leading cause of cancer-related deaths in Nigerian women, with triple-negative breast cancer (TNBC) being the most prevalent. The TNBC subtype is characterized by mutations in BRCA1 and BRCA2 genes, and germline pathogenic carriers of these mutations have an increased risk for BC. Despite these challenges, the prevalence and spectrum of BRCA1/2 pathogenic variants in the Nigerian population differ, and there is a margin in the local capacity to characterize these variations. Therefore, this study aimed to identify and characterize germline variations in BRCA 1/2 genes in Nigerian BC patients and healthy aged-matched controls to understand the genetic risk profiles of BC in this population. Forty-five BC patients were recruited across four major hospitals in Nigeria and aged-matched with 51 healthy female controls. DNA was extracted from blood samples, followed by targeted sequencing of BRCA 1/2 intronic and exonic regions using the Ampliseq for BRCA panel and the Illumina Miseq Platform. Variant calling was performed, and the clinical significance of identified variants was evaluated on the ClinVar and BRCA exchange databases. Variants of unknown significance (VUS) were assessed using known in silico prediction software, and haplotype analysis was carried out using the Haploview 4.2 software. Pathogenic variants were identified in 6.7% of cases, all exclusive to BC patients. These variants included two BRCA1 variants (3: c.133_134delAA (p.Lys45fs) and c.5324T>A (21: p.Met1775Lys), and one BRCA 2 variant (22: c.8817_8820del (p.Lys2939fs) all found in patients with the TNBC subtype. Additionally, 97 benign or likely benign BRCA1/2 variants were found in both BC and control groups, with notable variants such as the rs799917 identified as a surrogate indicator of ancestry. Eighteen VUS were identified, with four predicted to be damaging by three in silico prediction software. The results of haplotype analysis identified distinct BC haplotypes in Nigerian BC patients. The identification of BRCA1/2 pathogenic variants in Nigerian BC patients, especially those with TNBC, suggests a potential for targeted therapies, such as PARP inhibitors, to improve treatment outcomes in this population. This further highlights the need for increased population-specific screening and the integration of genetic screening into BC management strategies, which could facilitate early detection, personalized treatment plans, and genetic counseling for Nigerian BC patients.