PVS1
This missense variant does not create a nonsense, frameshift, canonical +/-1,2 splice, initiation-codon, or exon-level loss-of-function event, so the BRCA1 PVS1 rule is not met.
PS1
No evidence was identified showing that this variant causes the same protein or splicing consequence as a previously classified pathogenic or likely pathogenic BRCA1 variant, so PS1 was not assessed.
PS3
Available functional evidence does not support a damaging effect.
PS4
No case-control study or other quantitative prevalence data were identified showing that this variant is significantly enriched in affected individuals compared with controls, so PS4 was not assessed.
PM2
This variant is absent from gnomAD v2.1 but is present in gnomAD v4.1 at AF 2.49e-06 (4/1609246 alleles; highest subpopulation AF 4.81e-05, 3/62354), so it is not absent from population databases and PM2 is not applied.
PM3
No evidence was identified for biallelic BRCA1 variation in a proband with BRCA1-related Fanconi anemia, so PM3 was not assessed.
PM5
The ENIGMA BRCA1/2 PM5 rule is mainly used for protein-truncating variants in eligible exons, and no qualifying codon-level pathogenic comparator was identified for this missense variant, so PM5 was not assessed.
PP1
No quantitative co-segregation data were identified for affected relatives, so PP1 was not assessed.
PP3
Available predictive evidence does not meet the ENIGMA BRCA1/2 thresholds for PP3.
PP4
The BRCA1 clinical-history likelihood ratio for this variant is 0.688 in 2 probands, which is below the ENIGMA PP4 supporting threshold of 2.08, so PP4 is not met.