The BRCA proteins have multiple functions. One important role is in the repair of DNA damage. They have also been implicated in the regulation of gene expression. The BRCA-1 gene is associated with the activation of another tumor suppressor, p53, and its target gene p21. BRCA proteins also interact with transcription factors and other transcription components to control the activity of several other genes.(1) When the BRCA genes are non-functional, DNA repair and gene regulation are compromised. The increase in DNA damage can lead to the generation of cells that accumulate mutations in key genes, leading to cancer cell formation. Cells lacking functional BRCA genes often suffer from chromosomal breaks, severe aneuploidy, and may contain too many centrosomes. All of these defects interfere with normal cell division and cell function.
At the molecular level, the structure of the BRCA-1 and -2 genes provides an explanation for their susceptibility to mutation. They contain a very high proportion of repetitive DNA, which is rare in human genes. The repetitive DNA can lead to genomic instability and rearrangements. (1)
Several lines of work have demonstrated that loss of BRCA gene products is associated with the development of sporadic and inherited cancer.(1)
A Closer Look at Ovarian Cancer and BRCA
Although the BRCA genes were named after their association with breast cancer, mutations in these genes are also associated with ovarian cancers. The hereditary and sporadic forms of ovarian cancer are similar but there are some differences. Hereditary ovarian cancer tends to have a mostly serous( )histology, be moderately to poorly differentiated, invasive, and is usually discovered at an advanced stage. Also, BRCA mutation carriers have a higher frequency of lesions in the fallopian tubes. Whether the patient is a carrier of the mutation or not, benign and low malignant potential ovarian tumors are not considered precursors of invasive ovarian carcinoma.(2)>