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A U.S. breaker will still function properly on a 220V supply which has one side grounded. The only thing I can think of that might be of concern is whether the breaker is rated for such use. I believe that residential type 2-pole breakers are generally rated 120/240V and that to operate the breaker within its UL specifications you might need one rated for a straight 240V. I'm sure one of our U.S. members will step in here.

With regard to clearing a ground-fault, remember that in many parts of Europe the TT system is used, meaning that there is no direct bond between the building grounding system and the neutral. The regular breaker just acts as an overcurrent device, and a main GFI is fitted to protect against ground faults.