Base excision repair (BER) removes at least 20,000 DNA lesions per human cell per day and is critical for the maintenance of genomic stability. We hypothesize that aberrant BER, resulting from mutations in BER genes, can lead to genomic instability and cancer. The first step in BER is catalyzed by DNA N-glycosylases. One of these, n th endonuclease III-like (NTH1), removes oxidized pyrimidines from DNA, including thymine glycol. The rs3087468 single nucleotide polymorphism of the NTH1 gene is a G-to-T base substitution that results in the NTH1 D239Y variant protein that occurs in ∼6.2% of the global population and is found in Europeans, Asians, and subSaharan Africans. In this study, we functionally characterize the effect of the D239Y variant expressed in immortal but nontransformed human and mouse mammary epithelial cells. We demonstrate that expression of the D239Y variant in cells also expressing wild-type NTH1 leads to genomic instability and cellular transformation as assessed by anchorage-independent growth, focus formation, invasion, and chromosomal aberrations. We also show that cells expressing the D239Y variant are sensitive to ionizing radiation and hydrogen peroxide and accumulate double strand breaks after treatment with these agents. The DNA damage response is also activated in D239Y-expressing cells. In combination, our data suggest that individuals possessing the D239Y variant are at risk for genomic instability and cancer.DNA repair | mutagenesis | MCF10A breast epithelial cells T he base excision repair (BER) pathway is responsible for the removal of at least 20,000 DNA lesions per cell per day (1), making it critical for the maintenance of genomic stability. The simplest and most common form of BER is short patch BER, which can be initiated by one of several different DNA glycosylases, each having preferences for specific types of lesions (2). Monofunctional DNA glycosylases recognize DNA lesions and catalyze the hydrolysis of the N-glycosylic bond to generate an abasic site. The abasic site is nicked at its 5′ side by the APE1 endonuclease, leaving a 3′OH and a 5′deoxyribose phosphate (dRP). DNA polymerase beta (pol β) fills in the single nucleotide gap and catalyzes removal of the dRP group. Bifunctional glycosylases, which usually recognize oxidative lesions, generate an abasic site and then catalyze its removal via β-elimination to generate a 3′dRP and 5′phosphate. APE1 then catalyzes removal of the 3′dRP, leaving a 3′OH, to which pol β can bind and fill in the resulting single nucleotide gap. In both cases, the XRCC1/ Ligase IIIα or XRCC1/Ligase I complex catalyzes ligation of the resulting ends. An alternative BER pathway, that does not depend on APE1, is used when the NEIL glycosylases initiate repair (3). NEIL 1, 2, and perhaps 3 catalyze excision of the damaged base via β,δ elimination, leaving a 3′phosphate and a 5′phosphate. The 3′phosphate is removed by polynucleotide kinase, leaving a gap that is most often filled by pol β, followed by ligation.NTH1 is one of four human bifunctio...