Multimodal analysis of a rare BARD1 missense variant suggests its pathogenicity is conditional
Bibliographic record
Abstract
Hereditary breast cancer involves multiple risk genes, including BARD1, which confers low to moderate risk and is associated with triple-negative breast cancer (TNBC). We report a proband with a primary ER+/PR+/HER2- breast cancer, which recurred unilaterally as a TNBC and who later developed endometrial cancer. Clinical germline testing revealed a rare BARD1 missense variant of uncertain significance [c.2258G>T; p.(Gly753Val)]. Whole-exome sequencing of tumors and blood revealed BARD1 loss of heterozygosity and mutational signature 3 - indicative of homologous recombination (HR) repair deficiency - exclusively in the TNBC recurrence. Functional assays demonstrated impaired HR repair via increased PARP inhibitor sensitivity and reduced RAD51 foci formation. We hypothesize that the selective pressure exerted by tamoxifen resulted in breast cancer subtype switching and uncovered the pathogenic potential of the BARD1 p.(Gly753Val) variant. This case illustrates a previously unreported scenario where the pathogenicity of a germline BARD1 variant appears conditional on prior treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".