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A number of mutations with a combined frequency of 2%, each causing a 10-fold risk of the disease, could adequately explain the familial risks and the many multiple case families not due to BRCA1 or BRCA2.
Breast cancer cases were the youngest affected members of multiple case families (n = 71), ascertained through Family Cancer Clinics by the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer [ 14].
(d) Multiple case families: 'British' (B) families.
Data from large multiple case families suggest that there will be few other high penetrance genes.
Linkage studies in multiple case families, however, have failed to identify further major breast cancer genes [ 7].
The search for additional susceptibility genes will require very large numbers of highly selected groups of multiple case families.
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Mutations in high-risk susceptibility genes (mainly BRCA1 and BRCA2) explain most large multiple-case families, but account for only 15 to 20% of the excess familial risk [ 4].
Model-based linkage analysis in multiple-case families, followed by positional cloning, led to the identification of BRCA1 and BRCA2.
Multiple-case families with at least one case of male breast cancer are mainly due to BRCA2.
They found three multiple-case families in which one or other of these mutations segregated with breast cancer.
However, mutation carriers from multiple-case families constitute cohorts in which hypotheses about the role of potential modifying genes and non-genetic risk factors can be tested.
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