J.Jpn. Surg. Soc.. 127(3): 310-317, 2026

---

Feature topic

PLASTIC AND RECONSTRUCTIVE SURGERY/BREAST RECONSTRUCTION

In April 2020, genetic testing and risk-reducing surgery for hereditary breast and ovarian cancer (HBOC) syndrome became covered by health insurance in Japan. Although HBOC accounts for only about 5％ of breast cancers, bilateral reconstruction is increasing. When considering breast reconstruction, we began to more strongly consider the possibility of contralateral surgery even when breast cancer occurs unilaterally. The timing of resection and reconstruction may differ between the left and right sides, and this difference is the cause of the differing conditions between the two sides. However, symmetry is an important factor in the goals of reconstruction. If breast cancer treatment was performed before 2020, it became a metachronous bilateral procedure, and if an abdominal flap was initially selected, a different reconstruction method was chosen for the left and right sides. With the introduction of genetic testing, if HBOC is diagnosed at the initial onset, bilateral reconstruction can be considered from the beginning. However, as gene-positive individuals do not necessarily opt for risk-reducing surgery, reconstruction anticipating future contralateral surgery needs to be considered. The spread of genetic testing necessitates the consideration of bilateral surgery options at various stages when planning breast reconstruction, making it crucial to be able to accommodate diversity.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.