Two patients had alterations in RAD51X. RAD51C alterations are associated with familial predisposition for ovarian and breast cancers, whereas RAD51D alterations are associated with breast, ovarian, prostate, and GI cancers.12 One patient had a pathogenic alteration in TGFBR1, which occurs in connective tissue/skeletal conditions.13 One patient had an MSH-6 alteration, which is associated with Lynch syndrome. This evidence concerns the gene RAD51D and breast cancer.