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'''Table 1 - Clinically significant copy number alterations and regions of loss of heterozygosity in breast cancer.''' Table derived from Geiersbach et al., 2018 [[https://pubmed.ncbi.nlm.nih.gov/32087595/ PMID 32087595]] with permission from Cancer Genetics.<ref>{{Cite journal|last=Geiersbach|first=Katherine B.|last2=Chen|first2=Hui|last3=Emmadi|first3=Rajyasree|last4=Haskell|first4=Gloria T.|last5=Lu|first5=Xinyan|last6=Liu|first6=Yajuan J.|last7=Swisshelm|first7=Karen|date=2020-06|title=Current concepts in breast cancer genomics: An evidence based review by the CGC breast cancer working group|url=https://pubmed.ncbi.nlm.nih.gov/32087595|journal=Cancer Genetics|volume=244|pages=11–20|doi=10.1016/j.cancergen.2020.02.002|issn=2210-7762|pmid=32087595}}</ref>
 
{| class="wikitable"
 
{| class="wikitable"
 
|'''Alteration'''
 
|'''Alteration'''
 
|'''Relevant Gene(s)'''
 
|'''Relevant Gene(s)'''
|'''CGC Evidence Level'''
+
|'''CGC Evidence Level'''
 
|'''Subgroup Association(s)'''
 
|'''Subgroup Association(s)'''
 
|-
 
|-
 
|1q gain
 
|1q gain
| unknown
+
|unknown
 
|2
 
|2
 
|Most common copy number alteration, often with 16q loss; all subtypes
 
|Most common copy number alteration, often with 16q loss; all subtypes
 
|-
 
|-
 
|8p11.2 amplification
 
|8p11.2 amplification
|''FGFR1'', ''ZNF703''
+
|''[[FGFR1]]'', ''[[ZNF703]]''
 
|2
 
|2
 
|METABRIC IntClust6, ER positive
 
|METABRIC IntClust6, ER positive
 
|-
 
|-
 
|8q24 amplification
 
|8q24 amplification
|''MYC''
+
|''[[MYC]]''
 
|2
 
|2
 
|METABRIC IntClust9, ER positive
 
|METABRIC IntClust9, ER positive
 
|-
 
|-
 
|9p24 amplification
 
|9p24 amplification
|''JAK2, CD274, PDCD1LG2''
+
|''[[JAK2]], [[CD274]], [[PDCD1LG2]]''
 
|2
 
|2
 
|Enriched in TNBC
 
|Enriched in TNBC
 
|-
 
|-
 
|10q23.3 loss or LOH
 
|10q23.3 loss or LOH
|''PTEN''
+
|''[[PTEN]]''
 
|2
 
|2
 
|Enriched in TNBC and in lobular carcinoma
 
|Enriched in TNBC and in lobular carcinoma
 
|-
 
|-
 
|11q13-q14 gain / amplification
 
|11q13-q14 gain / amplification
|''CCND1'', ''EMS1'', and others
+
|''[[CCND1]]'', ''[[EMS1]]'', and others
 
|2
 
|2
 
|METABRIC IntClust2
 
|METABRIC IntClust2
 
|-
 
|-
 
|16q loss / LOH
 
|16q loss / LOH
|''CDH1''
+
|''[[CDH1]]''
 
|2
 
|2
 
|METABRIC IntClust2, ER positive
 
|METABRIC IntClust2, ER positive
 
|-
 
|-
 
|17p loss / LOH
 
|17p loss / LOH
|''TP53''
+
|''[[TP53]]''
 
|2
 
|2
 
|TNBC, basal-like intrinsic subtype
 
|TNBC, basal-like intrinsic subtype
 
|-
 
|-
 
|17q12 amplification
 
|17q12 amplification
|''ERBB2'' (''HER2'')
+
|''[[ERBB2]]'' (''HER2'')
 
|1
 
|1
 
|METABRIC IntClust5, HER2-enriched
 
|METABRIC IntClust5, HER2-enriched
 
|-
 
|-
 
|17q21 amplification
 
|17q21 amplification
|''TOP2A''
+
|''[[TOP2A]]''
 
|2
 
|2
 
|METABRIC IntClust5, HER2-enriched
 
|METABRIC IntClust5, HER2-enriched
 
|-
 
|-
 
|17q23 amplification (“17q distal amplicon”)
 
|17q23 amplification (“17q distal amplicon”)
|''RPS6KB'', others
+
|''[[RPS6KB]]'', others
 
|2
 
|2
 
|METABRIC IntClust1
 
|METABRIC IntClust1
 
|-
 
|-
 
|19q12
 
|19q12
|''CCNE1''
+
|''[[CCNE1]]''
 
|2
 
|2
 
|METABRIC IntClust5; HER2-enriched
 
|METABRIC IntClust5; HER2-enriched
 
|-
 
|-
 
|20q gain; 20q13 amp
 
|20q gain; 20q13 amp
|''AURKA'', ''GNAS'', ''ZNF217''
+
|''[[AURKA]]'', ''[[GNAS]]'', ''[[ZNF217]]''
 
|2
 
|2
 
|METABRIC IntClust1, ER Positive
 
|METABRIC IntClust1, ER Positive
 
|}
 
|}
 +
† See table below Table 2 for CGC Evidence levels
 +
 +
Abbreviations: TNBC, triple negative breast cancer; LOH, loss of heterozygosity.
 +
 +
 +
'''Table 2 - Major clinically significant genes associated with somatic sequence alterations in breast cancer.''' Table derived from Geiersbach et al., 2018 [[https://pubmed.ncbi.nlm.nih.gov/32087595/ PMID 32087595]] with permission from Cancer Genetics.
 +
{| class="wikitable"
 +
|'''Gene(s)'''
 +
|'''CGC Evidence Level'''†
 +
|'''Clinical Significance and Subgroup Association(s)'''
 +
|'''Therapy Implication(s)'''
 +
|-
 +
|''[[AKT1]]''
 +
|2
 +
|Metastatic BC
 +
|AKT inhibitors
 +
|-
 +
|''[[ATM]]''
 +
|1
 +
|Possible hereditary risk; TNBC
 +
|PARP inhibitors (germline)
 +
|-
 +
|''[[BRCA1]], [[BRCA2]]''
 +
|1
 +
|Often hereditary risk; TNBC
 +
|Platinum based therapy; PARP inhibitors (germline)
 +
|-
 +
|''[[CBFB]]''
 +
|2
 +
|ER-positive, Metastatic BC
 +
|
 +
|-
 +
|''[[CCND1]], [[CCNE1]]''*
 +
|2
 +
|HER2-enriched
 +
|CDK4/6 inhibitors
 +
|-
 +
|''[[CDK4]], [[CDK6]]''*
 +
|2
 +
|ER-positive, Metastatic BC
 +
|CDK4/6 inhibitors
 +
|-
 +
|''[[CDH1]]''
 +
|1
 +
|Lobular histology; Possible hereditary risk
 +
|
 +
|-
 +
|''[[CDKN2A]]''
 +
|2
 +
|Metastatic BC
 +
|
 +
|-
 +
|''[[CHEK2]]''
 +
|1
 +
|Often hereditary risk
 +
|PARP inhibitors (germline)
 +
|-
 +
|''[[ERBB2]]''*
 +
|1
 +
|Rare activating sequence alterations; kinase domain  resistance mutations; HER2-enriched
 +
|HER2-targeted therapy
 +
|-
 +
|''[[ESR1]]''
 +
|1
 +
|Metastatic ER-positive
 +
|Hormone therapy resistance
 +
|-
 +
|''[[FGFR1]], [[FGFR2]], [[FGFR3]], [[FGFR4]]''
 +
|2
 +
|ER-positive
 +
|FGFR inhibitors
 +
|-
 +
|''[[FOXA1]]''
 +
|2
 +
|ER-positive, Luminal subtype, lobular histology
 +
|
 +
|-
 +
|''[[GATA3]]''
 +
|2
 +
|ER-positive, Luminal subtype
 +
|
 +
|-
 +
|''[[JAK2]]''*
 +
|2
 +
|TNBC
 +
|JAK2 inhibitors, immunotherapy
 +
|-
 +
|''[[MAP2K4]]''
 +
|2
 +
|Metastatic BC
 +
|
 +
|-
 +
|''[[MAP3K1]]''
 +
|2
 +
|ER-positive, Metastatic BC
 +
|
 +
|-
 +
|''[[MYC]]''*
 +
|2
 +
|
 +
|
 +
|-
 +
|''[[NBN]]''
 +
|1
 +
|Possible hereditary risk
 +
|PARP inhibitors (germline)
 +
|-
 +
|''[[NF1]]''
 +
|1
 +
|Possible hereditary risk
 +
|mTOR/PI3K/AKT inhibitors (germline)
 +
|-
 +
|''[[NTRK1]], [[NTRK2]], [[NTRK3]]''
 +
|1
 +
|
 +
|NTRK inhibitors
 +
|-
 +
|''[[PALB2]]''
 +
|1
 +
|Often hereditary risk
 +
|PARP inhibitors (germline)
 +
|-
 +
|''[[PIK3CA]]''
 +
|1
 +
|ER-Positive, Luminal subtype
 +
|PI3K inhibitors for selected hotspot mutations; acquired hormone resistance
 +
|-
 +
|''[[PTEN]]''
 +
|2
 +
|Loss in lobular BC
 +
 +
Possible hereditary risk
 +
|mTOR/PI3K/AKT inhibitors; radiation contraindicated
 +
|-
 +
|''[[RB1]]''
 +
|2
 +
|Metastatic BC
 +
|Acquired hormone resistance
 +
|-
 +
|''[[STK11]]''
 +
|1
 +
|Possible hereditary risk
 +
|
 +
|-
 +
|''[[TBX3]]''
 +
|2
 +
|Lobular BC
 +
|
 +
|-
 +
|''[[TOP2A]]''*
 +
|2
 +
|
 +
|Anthracycline inhibitors
 +
|-
 +
|''[[TP53]]''
 +
|1
 +
|TNBC, HER2-enriched, Metastatic BC
 +
 +
Possible hereditary risk
 +
|Radiation contraindicated
 +
|}
 +
<nowiki>*</nowiki> Indicates genes more commonly activated by amplification than by sequence variation
 +
 +
Abbreviations: BC, breast cancer. TNBC, triple negative breast cancer.
 +
 +
†'''Cancer Genomics Consortium Levels of Evidence'''
 +
{| class="wikitable"
 +
|'''Tier'''
 +
|'''Data Source(s)'''
 +
|'''Interpretation'''
 +
|-
 +
|1
 +
|FDA approved therapies, professional guidelines, multiple large clinical studies
 +
|Strong evidence supporting clinical utility of variant(s) for diagnosis, selection of therapies, or predicting disease outcome
 +
|-
 +
|2
 +
|One large study or multiple case reports
 +
|Emerging evidence supporting clinical utility of variant(s)
 +
|-
 +
|3
 +
|Case reports or expert opinion
 +
|Unknown clinical significance
 +
|-
 +
|4
 +
|Published evidence indicating lack of pathogenicity of variant(s)
 +
|Benign or likely benign
 +
|}
 +
 +
 +
'''Table 3 - Genes with known hereditary risk associations in breast cancer.''' Table derived from Geiersbach et al., 2018 [[https://pubmed.ncbi.nlm.nih.gov/32087595/ PMID 32087595]] with permission from Cancer Genetics.
 +
{| class="wikitable"
 +
|'''Gene'''
 +
|'''Associated Syndrome; Breast Cancer Subtype'''
 +
|-
 +
|''[[ATM]]''
 +
|Ataxia telangiectasia syndrome
 +
|-
 +
|''[[BARD1]]''
 +
|TNBC
 +
|-
 +
|''[[BRCA1]]''
 +
|[[BRCA1 syndrome|BRCA-Related Breast/ Ovarian Cancer Syndrome]]; TNBC
 +
|-
 +
|''[[BRCA2]]''
 +
|[[BRCA2 syndrome|BRCA-Related Breast/ Ovarian Cancer Syndrome]]; TNBC
 +
|-
 +
|''[[CDH1]]''
 +
|Hereditary Diffuse Gastric Cancer and Lobular Breast Cancer
 +
|-
 +
|''[[CHEK2]]''
 +
|Inherited breast cancer
 +
|-
 +
|''[[NBN]]''
 +
|Nijmegen Breakage Syndrome
 +
|-
 +
|''[[NF1]]''
 +
|Neurofibromatosis type 1
 +
|-
 +
|''[[PALB2]]''
 +
|Fanconi anemia
 +
|-
 +
|''[[PTEN]]''
 +
|Cowden syndrome
 +
|-
 +
|''[[RAD51C]]''
 +
|TNBC
 +
|-
 +
|''[[RAD51D]]''
 +
|TNBC
 +
|-
 +
|''[[STK11]]''
 +
|Peutz-Jeghers syndrome
 +
|-
 +
|''[[TP53]]''
 +
|Li-Fraumeni syndrome
 +
|}
 +
Abbreviations: TNBC, triple negative breast cancer.
 +
==Reference==
 +
<references />