Confirmed germline pathogenic / likely-pathogenic monoallelic variant in ATM (heterozygou...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | RF-ATM-CONFIRMED-CARRIER |
|---|---|
| Тип | Тривожна ознака |
| Статус | переглянуто 2026-05-19 | очікує клінічного підпису |
| Хвороби | DIS-BREAST DIS-PDAC DIS-PROSTATE |
| Джерела | SRC-NCCN-BREAST-2025 SRC-NCCN-GENETIC-FAMILIAL-BREAST-OVARIAN-2025 |
Походження тривожної ознаки
| Визначення | Confirmed germline pathogenic / likely-pathogenic monoallelic variant in ATM (heterozygous; biallelic ATM is the autosomal-recessive Ataxia-Telangiectasia phenotype, distinct from the cancer-predisposition carrier state covered here). Heterozygous ATM carriers have moderate- penetrance breast cancer risk (RR ~2.0-2.4; lifetime breast cancer risk ~20-30%), pancreatic adenocarcinoma (RR ~5-10, lifetime ~5-9%), prostate cancer (RR ~2-3 with high-grade enrichment), and possibly gastric + colorectal modest signals. Specific variants — c.7271T>G (p.Val2424Gly) + truncating loss-of-function — confer higher breast cancer risk than missense variants of uncertain significance. Common multi-gene panel finding (~1% population carrier frequency). Patient has confirmed positive germline test; no current personal cancer diagnosis in the carrier being assessed. Prevention-persona RedFlag (§20, v0.3 mod... |
|---|---|
| Клінічний напрям | investigate |
| Категорія | other |
Логіка спрацьовування
{
"any_of": [
{
"finding": "germline_atm_pathogenic_variant_confirmed",
"value": true
},
{
"finding": "germline_atm_likely_pathogenic_variant",
"value": true
}
],
"type": "lab_value"
}
Нотатки
Prevention-persona RedFlag for ATM heterozygous carriers. Distinction from biallelic A-T phenotype is critical: heterozygotes have cancer predisposition only (no neurologic phenotype). Engine routes to enhanced breast surveillance + pancreatic surveillance for FDR-of- PDAC carriers per CAPS consortium 2022; prostate awareness for males. STUB pending two-Co-Lead signoff per CHARTER §6.1 dev-mode.
Де використовується
Indications
IND-ATM-CARRIER-PREVENTION-OBSERVATION- IND-ATM-CARRIER-PREVENTION-OBSERVATIONIND-ATM-CARRIER-PREVENTION-SURVEILLANCE- IND-ATM-CARRIER-PREVENTION-SURVEILLANCEIND-ATM-SUSPICION-PREVENTION-TESTING- IND-ATM-SUSPICION-PREVENTION-TESTING
Тривожна ознака
RF-ATM-FAMILY-HISTORY-SUSPICION- Family pedigree pattern suggestive of germline ATM heterozygous carrier state in an asymp...