Pathogenic sequence variants (PSV) in BRCA1 or BRCA2 (BRCA1/2) are associated with increased risk and severity of prostate cancer. We evaluated whether PSVs in BRCA1/2 were associated with risk of overall prostate cancer or high grade (Gleason 8þ) prostate cancer using an international sample of 65 BRCA1 and 171 BRCA2 male PSV carriers with prostate cancer, and 3,388 BRCA1 and 2,880 BRCA2 male PSV carriers without prostate cancer. PSVs in the 30 region of BRCA2 (c.7914þ) were significantly associated with elevated risk of prostate cancer compared with reference bin c.1001c.7913 [HR 1⁄4 1.78; 95% confidence interval (CI), 1.25–2.52; P 1⁄4 0.001], as well as elevated risk of Gleason 8þ prostate cancer (HR 1⁄4 3.11; 95% CI, 1.63–5.95; P 1⁄4 0.001). c.756-c.1000 was also associated with elevated prostate cancer risk (HR 1⁄4 2.83; 95% CI, 1.71–4.68; P 1⁄4 0.00004) and elevated risk of Gleason 8þ prostate cancer (HR 1⁄4 4.95; 95% CI, 2.12–11.54; P 1⁄4 0.0002). No genotype–phenotype associations were detected for PSVs in BRCA1. These results demonstrate that specific BRCA2 PSVs may be associated with elevated risk of developing aggressive prostate cancer.
