title: Collaboration of breast cancer clinic and genetic counseling division for BRCA1 and BRCA2 mutation family in Japan.
abstract: BACKGROUND
  BRCA1 and BRCA2 mutations cause high breast cancer incidence rates as high as 80% Although prophylactic therapy is still controversial, several prophylactic therapies have been proposed and tried for BRCA1 and BRCA2 mutation carriers. Prophylactic surgery, chemo-prevention and precise screening have been proposed as prophylactic therapy. All BRCA1 and BRCA2 mutation carriers need knowledge about their disease and the countermeasures that are used to protect against onset of disease. Counseling plays an important role in this regard for people with genetic diseases. Therefore, collaboration between breast cancer clinics and genetic counseling services is the most important issue in clinical practice. Our group consists of three national universities and a general hospital. In this article we describe our trial to construct a clinical system against hereditary breast cancer as an interim report for the Japanese Ministry of Health, Labour and Welfare.
  
  
  METHODS
  Twenty familial breast cancer patients were registered in this study. The whole sequence of BRCA1 and BRCA2 were analyzed. If pathological mutations were detected, their first degree families were introduced to the counseling division at each institute when candidates visited counseling divisions.
  
  
  CONCLUSIONS
  Four cases of a deleterious mutation in BRCA1 or BRCA2 were detected among 20 cases. Their first degree relatives are now under consideration for visiting counseling divisions. The clinical system described in this study should play a role to protect BRCA1 or BRCA2 mutation carriers in Japan.
authors.affiliation: Division of Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aobaku, Sendai 980-8574, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Takeda
authors.forename: Takanori
authors.initials: T
authors.lastname: Ishida
authors.forename: Kohji
authors.initials: K
authors.lastname: Ohnuki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Masato
authors.initials: M
authors.lastname: Sakayori
authors.forename: Chikashi
authors.initials: C
authors.lastname: Ishioka
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nomizu
authors.forename: Shinzaburou
authors.initials: S
authors.lastname: Noguchi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Matsubara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics*; D005260:Female; D019398:Genes, BRCA1 / Q000502:physiology*; D024522:Genes, BRCA2 / Q000502:physiology*; D005817:Genetic Counseling / Q000379:methods / Q000458:organization & administration*; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D007564:Japan; D016522:Oncology Service, Hospital