MBD4 Biallelic gene - Cancer risk, management, and testing for genetic mutations

Associated Syndrome Name: MBD4-associated neoplasia syndrome (MANS)

MBD4 Biallelic Summary Cancer Risk Table

Cancer Genetic Cancer Risk
ColorectalElevated Risk
OtherElevated Risk

MBD4 Biallelic gene Overview

MBD4-associated neoplasia syndrome (MANS) 1, 2, 3
  • Individuals with mutations in both copies of MBD4 (biallelic) have MBD4-associated neoplasia syndrome (MANS).
  • MBD4 biallelic mutations have been identified in some individuals with colon polyps, ranging from few to over 100 colon polyps, suggesting a variable polyposis presentation.
  • Studies have reported multiple individuals with MBD4 biallelic mutations who have developed blood disorders such as myelodysplastic syndrome (MDS) and/or acute myelogenous leukemia (AML).  The exact size of this risk is unknown.
  • Uveal melanoma has been reported in numerous individuals with a mutation in one copy of the MBD4 gene (monoallelic).  However, it is unknown whether individuals with mutations in both copies of the MBD4 gene are at an increased risk for uveal melanoma.
  • Although there are increased risks for cancer in individuals with MBD4 biallelic mutations, there are interventions that may reduce these risks. Guidelines from the National Comprehensive Cancer Network (NCCN) are listed below.

MBD4 Biallelic gene Cancer Risk Table

Cancer Type Age Range Cancer Risk Risk for General Population
ColorectalTo age 801, 3, 4Elevated risk2.8%
LeukemiaTo age 801, 4Elevated risk1.1%
Uveal MelanomaTo age 802Possibly elevated<0.1%

MBD4 Biallelic Cancer Risk Management Table

The overview of medical management options provided is a summary of professional society guidelines. The most recent version of each guideline should be consulted for more detailed and up-to-date information before developing a treatment plan for a particular patient.

This overview is provided for informational purposes only and does not constitute a recommendation. While the medical society guidelines summarized herein provide important and useful information, medical management decisions for any particular patient should be made in consultation between that patient and his or her healthcare provider and may differ from society guidelines based on a complete understanding of the patient’s personal medical history, surgeries and other treatments.

Cancer Type Procedure Age to Begin Frequency
(Unless otherwise indicated by findings)
ColorectalColonoscopy118 to 20 yearsEvery 2 to 3 years
LeukemiaComplete blood count (CBC)1, 5At time of diagnosis of MANSEvery 6 to 12 months
Bone marrow aspirate and biopsy5At time of diagnosis of MANSAnnually
Uveal MelanomaEye exam1At time of diagnosis of MANSAnnually

Benefits of Testing for MBD4 Biallelic Gene Mutations:

Testing for MBD4 Biallelic gene mutations with the MyRisk® Hereditary Cancer Test with RiskScore® provides critical insights to patients and providers about potential hereditary cancer risk. Identifying a MBD4 Biallelic gene mutation can help clarify whether a patient is at increased risk for certain cancers and guide proactive, personalized care planning. With definitive answers from the MyRisk Test, healthcare providers can better tailor screening, prevention, and management strategies, while patients gain clarity and confidence about their hereditary cancer risk. In addition, understanding a MBD4 Biallelic gene mutation allows family members to consider their own hereditary cancer risk, supporting informed decision-making and potentially life-saving early interventions. Learn more about the MyRisk® with RiskScore® Hereditary Cancer Test.

Information for Family Members

The following information for Family Members will appear as part of the MMT for a patient found to have a mutation in the MBD4 Biallelic gene.

This patient's relatives are at risk for carrying the same mutation(s) and associated cancer risks as this patient. Cancer risks for females and males who have this/these mutation(s) are provided below.

Family members should talk to a healthcare provider about genetic testing. Close relatives such as parents, children, brothers and sisters have the highest chance of having the same mutation(s) as this patient. Other more distant relatives such as cousins, aunts, uncles, and grandparents also have a chance of carrying the same mutation(s). Testing of at-risk relatives can identify those family members with the same mutation(s) who may benefit from surveillance and early intervention.

Since this patient has mutations in both copies of the MBD4 gene, it is almost certain each of their parents and all their children carry at least one of these MBD4 mutations. Siblings are at very high risk for carrying either one or two MBD4 mutations. Since even a single MBD4 mutation can lead to an increased risk for cancer, it is especially important that this information be shared within the family and relatives talk with a healthcare provider about testing. The cancer risk tables that follow provide cancer risks for individuals with mutations in either one (monoallelic) or both (biallelic) copies of the MBD4 gene.

References

  1. Gupta S, et al. NCCN Clinical Practice Guidelines in Oncology® Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric. V 1.2025. Jun 13. Available at https://www.nccn.org.
  2. Villy MC, et al. Familial uveal melanoma and other tumors in 25 families with monoallelic germline MBD4 variants. J Natl Cancer Inst. 2024 Apr 5;116(4):580-587. PMID: 38060262.
  3. Palles C, et al. Germline MBD4 deficiency causes a multi-tumor predisposition syndrome. Am J Hum Genet. 2022 May 5;109(5):953-960. PMID: 35460607.
  4. SEER*Explorer: An interactive website for SEER cancer statistics [Internet]. Surveillance Research Program, National Cancer Institute. [Cited 2025 Aug 12]. Available from https://seer.cancer.gov/explorer/.
  5. Maese LD, et al. Update on Recommendations for Surveillance for Children with Predisposition to Hematopoietic Malignancy. Clin Cancer Res. 2024 Oct 1;30(19):4286-4295. PMID: 39078402.
Last Updated on 15-Sep-2025