BRCA Database Submission Form

Please fill out this form to submit new BRCA sequence variations to the database. This form should also be used to update clinical information or to phenotype of variants already in the database. Submissions will be reviewed before they are added to the database and the submitter may be contacted for clarification or additional information. For this reason, valid contact information is required to make a submission. If you have any questions or concerns about the submission process, please contact Rong Mao ( at ARUP Laboratories. If you have multiple mutations to submit, you can also contact us about an efficient transfer of this data into the database.

Required Fields *

Note: Please describe your variant according to current recommendations by the HGVS, especially for mutations causing truncation or changing the normal protein reading frame. Additional information can be added into the comments section.

Gene *
Location * Example: Exon11
Nucleotide Change * Example: c.197C>T, c.564+36A>G (no spaces)
Other description Example: Exon 3 is deleted (free text)
Protein Change * Example: p.T440M (no spaces)
Clinical Significance

Family History*
* observed in *

Immunohistochemistry Results
ER Status:
PR Status:
Histological Type:
Grade: *
# of times seen
Publication Information

Contact Information

Contact Name*
Institution Name*
Postal Code