Fanconi anemia is a genetically heterogeneous autosomal recessive disorder characterized by development abnormalities, bone marrow failure, and childhood cancers. Compelling evidence indicates a common genetic basis for FA and breast/ovarian cancer susceptibility. Recently, biallelic germ-line mutations in SLX4 have been demonstrated to cause a previously unknown FA subtype (FA-P). We address the role of SLX4/FANCP in breast/ovarian cancer susceptibility by conducting a comprehensive mutation scanning in 486 index cases from non-BRCA1/BRCA2 multiple-case breast and/or ovarian cancer families (non-BRCA1/2 families) from Spain. We detected one unequivocal loss-of-function mutation (p.Glu1517X). In addition, one missense change (p.Arg372Trp) predicted to be pathogenic by in silico analysis co-segregates with disease in one family. Overall, the study indicates that SLX4 mutation screening will have a very low impact (if any) in the genetic counseling of non-BRCA1/2 families. Fanconi Anemia (FA) is a genetically heterogeneous rare autosomal recessive disorder characterized by developmental abnormalities, bone marrow failure, and childhood cancers. 2 Somehow unexpectedly, a common genetic basis for breast/ovarian cancer susceptibility and FA emerged when biallelic BRCA2 loss-of-function mutations were identified in FA type D1 patients. 3 Later, mutations in FANCJ/BRIP1, FANCN/PALB2, FANCO/RAD51C, and XRCC2 have been found to lead both to FA (when biallelic) and to increased breast cancer risk (when monoallelic). [4][5][6][7] Recently, two studies have demonstrated that SLX4 loss-offunction biallelic mutations explain a novel FA subgroup (FANCP). 8,9 Not surprisingly, both reports suggest that SLX4 might be a breast and/or ovarian cancer predisposing gene. So far, this hypothesis has been tested by analyzing SLX4 in 52 German/ Byelorussian, 94 Spanish and 526 Italian non-BRCA1/2 families, but obvious loss-of-function germ-line mutations (or any other evidence supporting a causative role) have not been reported. [10][11][12] To further investigate the role of SLX4 in breast/ovarian cancer susceptibility, we have performed a comprehensive scanning of germ-line mutations in a cohort of 486 index cases from Spanish non-BRCA1/2 families.
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