Germline mutations of the breast cancer predisposing known genes, BRCA1 and BRCA2, with an autosomal dominant transmission explain only a part of the familial aggregation of breast cancer. Mainly involved in families with cases of ovarian cancer or male breast cancer, they account for a small proportion of families where only female breast cancer cases are observed. A third predisposing gene, called BRCA3, has been sought for a long time but without success. Recently, genetic epidemiology studies have shown evidence for non-mendelian inheritance. The familial residual risk non due to BRCA1 or BRCA2 genes could be explain by a polygenic model, corresponding to the multiplicative effects of several genes, more frequent in population but conferring moderate risks of cancer. The identification of these low penetrance genes is the challenge over the next years. We present here a focusing of recent knowledge on breast cancer predisposing genes, the perspectives of research and their implications in the practice of genetic counselling.
Copyright John Libbey Eurotext 2003.