J.Jpn. Surg. Soc.. 127(3): 305-309, 2026

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Feature topic

IMPACT OF GENETIC TESTING ON SURGICAL MANAGEMENT OF HEREDITARY BREAST AND OVARIAN CANCER

Advances in genetic testing have increasingly influenced surgical decision-making in breast cancer care. Among hereditary cancer syndromes, hereditary breast and ovarian cancer syndrome (HBOC), primarily caused by germline BRCA1/2 mutations, has transformed the role of surgery from tumor control toward long-term risk management. Identification of BRCA mutations enables risk-adapted surgical strategies, including risk-reducing mastectomy and contralateral prophylactic mastectomy, which significantly decrease the incidence of subsequent breast cancer. These procedures represent a paradigm shift toward preventive surgery based on genetic risk. At the same time, surgical planning must integrate oncological safety, reconstructive options, psychological impact, and patient values. Genetic diagnosis does not dictate a uniform surgical extent but provides a framework for individualized decision-making. In the era of genetic medicine, breast surgery has evolved into a form of risk-oriented surgery. Surgeons are increasingly expected to understand genetic information and to collaborate with multidisciplinary teams to support informed, patient-centered treatment decisions. HBOC represents a paradigmatic model illustrating how genetic diagnosis reshapes modern surgical oncology.

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