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While double heterozygosity in gBRCA1 and gBRCA2 has been reported in the past, herein we describe the first case of three known concurrent pathogenic variants identified in a family with a strong history of breast cancer.<\/jats:p><jats:p>Case presentation<\/jats:p><jats:p>The proband is a 55-year-old female diagnosed with synchronous bilateral breast cancers. She underwent a multi-gene panel testing indicating the presence of 3 concurrent heterozygous germline deleterious\u00a0variants in<jats:italic>BRCA1<\/jats:italic>(<jats:italic>c.181T<\/jats:italic>\u2009&gt;\u2009<jats:italic>G)<\/jats:italic>, BRCA2 (<jats:italic>c.4398_4402delACATT<\/jats:italic>), and CHEK2 (<jats:italic>1100delC<\/jats:italic>). The patient\u2019s two daughters (34 and 29\u00a0years-old) were found to be transheterozygous for inherited pathogenic variants in BRCA1<jats:italic>(c.181T<\/jats:italic>\u2009&gt;\u2009<jats:italic>G)<\/jats:italic>and CHEK2<jats:italic>(1100delC)<\/jats:italic>genes<jats:italic>.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The cancer risk and phenotypic manifestations associated with transheterozygous or multiple concurrent deleterious germline variants in hereditary breast cancer requires further investigation. A personalized approach to counseling, screening, and risk reduction should be undertaken for these individuals.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s10549-021-06095-w","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T15:03:36Z","timestamp":1611846216000},"page":"569-575","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Concurrent germline BRCA1, BRCA2, and CHEK2 pathogenic variants in hereditary breast cancer: a case series"],"prefix":"10.1007","volume":"186","author":[{"given":"Jasmine","family":"Sukumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Kassem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Agnese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Pilarski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhuvaneswari","family":"Ramaswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Sweet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4648-4018","authenticated-orcid":false,"given":"Sagar","family":"Sardesai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"issue":"13","key":"6095_CR1","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1200\/JCO.2015.65.0747","volume":"34","author":"N Tung","year":"2016","unstructured":"Tung N, Lin NU, Kidd J, Allen BA, Singh N, Wenstrup RJ et al (2016) Frequency of germline mutations in 25 cancer susceptibility genes in a sequential series of patients with breast cancer. 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