{"id":1266,"date":"2019-04-11T21:17:33","date_gmt":"2019-04-11T21:17:33","guid":{"rendered":"https:\/\/blogs.bmj.com\/jmg\/?p=1266"},"modified":"2026-02-24T00:43:23","modified_gmt":"2026-02-24T00:43:23","slug":"towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/jmg\/2019\/04\/11\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\/","title":{"rendered":"Towards controlled terminology for reporting germline cancer susceptibility variants: an ENIGMA report (Contributed by Dr. Amanda B Spurdle and Prof. Diana M Eccles)"},"content":{"rendered":"<p>The Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA &#8211; <a href=\"https:\/\/enigmaconsortium.org\/\">https:\/\/enigmaconsortium.org\/<\/a>) is a global research active consortium in which members have expertise in developing and bringing together a robust evidence base to underpin robust clinical utilization of inherited variants in breast and ovarian cancer susceptibility genes. The consortium was created a decade ago in 2009 and initially concentrated on BRCA1 and BRCA2 broadening its perspective to other (alleged) breast cancer susceptibility genes as these have become increasingly part of the genetic testing for breast cancer offering. ENIGMA is recognized by ClinGen as the expert interpretation group for BRCA1 and BRCA2 variant interpretation assigning ENIGMA interpretations to a 3* classification.<\/p>\n<p>The work described in this paper draws together a wealth of experience from ENIGMA consortium members\u2019 activities in the field. It recognizes the widely varying perspectives on the true meaning of many of the words that we use in different fields to describe and report genetic variants. Add to this the complexity of evidencing penetrance estimates and terminology to reflect different inferences, plus the potential for misrepresentation of the literature following translation into another field of expertise and another language, the potential for the final translation of a rapidly expanding area of risk prediction to tip from benefit to harm for recipients of results is clear.\u00a0 To address this, the consortium has reviewed the current use of terminology across all relevant disciplines involved in generating evidence, provided a summary description of frequently used <em>in silico<\/em> variant interpretation tools and proposed a draft framework for more consistent use of vocabulary used in research reports and in clinical reporting to facilitate a common understanding. Finally the paper sets out a tiered approach to translating cancer susceptibility genetic variants into clinical care recommendations incorporating assessment and acknowledgement of the robustness and linking level of risk to the \u201cseverity\u201d of any clinical intervention aimed at mitigating risk. (<a href=\"https:\/\/jmg.bmj.com\/content\/early\/2019\/04\/08\/jmedgenet-2018-105872\">https:\/\/jmg.bmj.com\/content\/early\/2019\/04\/08\/jmedgenet-2018-105872<\/a> )<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/jmg\/2019\/04\/11\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\/a-spurdle-hs\/\" rel=\"attachment wp-att-1267\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-1267\" src=\"https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-300x300.jpg 300w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-150x150.jpg 150w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-768x768.jpg 768w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-1024x1024.jpg 1024w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-640x640.jpg 640w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS-250x250.jpg 250w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Dr. Amanda B Spurdle<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/jmg\/2019\/04\/11\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\/d-eccles-20\/\" rel=\"attachment wp-att-1268\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-1268\" src=\"https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/D.Eccles-20-200x300.jpg\" alt=\"\" width=\"296\" height=\"444\" srcset=\"https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/D.Eccles-20-200x300.jpg 200w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/D.Eccles-20-768x1152.jpg 768w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/D.Eccles-20-683x1024.jpg 683w, https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/D.Eccles-20-640x960.jpg 640w\" sizes=\"auto, (max-width: 296px) 100vw, 296px\" \/><\/a><\/p>\n<p>Prof. Diana M Eccles<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA &#8211; https:\/\/enigmaconsortium.org\/) is a global research active consortium in which members have expertise in developing and bringing together a robust evidence base to underpin robust clinical utilization of inherited variants in breast and ovarian cancer susceptibility genes. The consortium was created a decade ago [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/jmg\/2019\/04\/11\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":123,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1266","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Towards controlled terminology for reporting germline cancer susceptibility variants: an ENIGMA report (Contributed by Dr. Amanda B Spurdle and Prof. Diana M Eccles) - JMG Contact blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/jmg\/2019\/04\/11\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Towards controlled terminology for reporting germline cancer susceptibility variants: an ENIGMA report (Contributed by Dr. Amanda B Spurdle and Prof. Diana M Eccles) - JMG Contact blog\" \/>\n<meta property=\"og:description\" content=\"The Evidence-based Network for the Interpretation of Germline Mutant Alleles (ENIGMA &#8211; https:\/\/enigmaconsortium.org\/) is a global research active consortium in which members have expertise in developing and bringing together a robust evidence base to underpin robust clinical utilization of inherited variants in breast and ovarian cancer susceptibility genes. The consortium was created a decade ago [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/jmg\/2019\/04\/11\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\/\" \/>\n<meta property=\"og:site_name\" content=\"JMG Contact blog\" \/>\n<meta property=\"article:published_time\" content=\"2019-04-11T21:17:33+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-02-24T00:43:23+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/jmg\/files\/2019\/04\/A-Spurdle-HS.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"3201\" \/>\n\t<meta property=\"og:image:height\" content=\"3201\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"hqqu\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@HuiQiQu\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"hqqu\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/\"},\"author\":{\"name\":\"hqqu\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/#\\\/schema\\\/person\\\/be0250f8d5b52412c3e7c222dabd591b\"},\"headline\":\"Towards controlled terminology for reporting germline cancer susceptibility variants: an ENIGMA report (Contributed by Dr. Amanda B Spurdle and Prof. Diana M Eccles)\",\"datePublished\":\"2019-04-11T21:17:33+00:00\",\"dateModified\":\"2026-02-24T00:43:23+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/\"},\"wordCount\":353,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/files\\\/2019\\\/04\\\/A-Spurdle-HS-300x300.jpg\",\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/jmg\\\/2019\\\/04\\\/11\\\/towards-controlled-terminology-for-reporting-germline-cancer-susceptibility-variants-an-enigma-report\\\/\",\"name\":\"Towards controlled terminology for reporting germline cancer susceptibility variants: an ENIGMA report (Contributed by Dr. Amanda B Spurdle and Prof. Diana M Eccles) - 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