J.Jpn. Surg. Soc.. 122(3): 314-319, 2021

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Feature topic

CURRENT STATUS OF HEREDITARY BREAST AND OVARIAN CANCER SYNDROME AND FUTURE PERSPECTIVES

All cancers are caused by genetic alterations but not all are hereditary. In the USA and Europe, about 5% to 10% of breast cancers are thought to be hereditary. The incidence of breast cancer in Japan has rapidly increased to 100,000 cases per year. The ratio of hereditary breast and ovarian cancer (HBOC) cases is assumed to be almost the same in Japan as in other countries. Therefore, we established the Japanese Organization for Hereditary Breast and Ovarian Cancer (JOHBOC) in July 2016. The mission of the JOHBOC includes: 1) maintaining an HBOC data registry; 2) providing education on HBOC to medical professionals, patients, and their families; and 3) conducting clinical research related to the management of HBOC. Risk-reducing mastectomy and risk-reducing salpingo-oophrectomy have been covered under Japanese National Health Insurance since April 2020. Chemoprevention (tamoxifen therapy for the prevention of breast cancer caused by BRCA2) is now being funded by the Japan Agency for Medical Research and Development. Multigene testing will soon be introduced in Japan. Therefore, the proper management of other genetic mutations that cause breast cancer should be established in the clinical guidelines. The expansion of public health insurance coverage for non-affected careers remains to be resolved in the near future.

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