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Background  The germline  TP53 -R337H mutation is strongly associated with pediatric adrenocortical tumors (ACT) in southern Brazil; it has low penetrance and limited tissue specificity in most families and therefore is not associated with Li-Fraumeni syndrome. However, other tumor types, mainly breast cancer, have been observed in carriers of several unrelated kindreds, raising the possibility that the R337H mutation may also contribute to breast tumorigenesis in a genetic background-specific context.    Methods  We conducted a case-control study to determine the prevalence of the R337H mutation by sequencing  TP 53 exon 10 in 123 women with breast cancer and 223 age- and sex-matched control subjects from southern Brazil. Fisher's test was used to compare the prevalence of the R337H.    Results  The R337H mutation was found in three patients but in none of the controls (p = 0.0442). Among the carriers, two had familial history of cancer meeting the Li-Fraumeni-like criteria. Remarkably, tumors in each of these three cases underwent loss of heterozygosity by eliminating the mutant  TP53  allele rather than the wild-type allele. Polymorphisms were identified within the  TP53  (R72P and Ins16) and  MDM2  (SNP309) genes that may further diminish  TP53  tumor suppressor activity.    Conclusion  These results demonstrate that the R337H mutation can significantly increase the risk of breast cancer in carriers, which likely depends on additional cooperating genetic factors. These findings are also important for understanding how low-penetrant mutant  TP53  alleles can differentially influence tumor susceptibility.

Association of the germline TP53R337H mutation with breast cancer in southern Brazil