title: Experience of risk-reducing salpingo-oophorectomy for a BRCA1 mutation carrier and establishment of a system performing a preventive surgery for hereditary breast and ovarian cancer syndrome in Japan: our challenges for the future.
abstract: BACKGROUND
  Risk-reducing salpingo-oophorectomy is currently regarded as the most certain primary method for preventing ovarian cancer among BRCA1/2 mutation carriers with hereditary breast and ovarian cancer syndrome. However, risk-reducing salpingo-oophorectomy has rarely been performed in Japan.
  
  
  METHODS
  We developed the first system in Japan for performing risk-reducing salpingo-oophorectomy for BRCA1/2 mutation carriers at our university hospital in 2008.
  
  
  RESULTS
  The indication for risk-reducing salpingo-oophorectomy for patients with hereditary breast/ovarian cancer syndrome is currently limited in Japan. This situation may be because of the limited number of genetic counseling units, the limited number of facilities that can perform BRCA1/2 genetic testing and the fact that prophylactic surgery is not covered by health insurance in Japan.
  
  
  CONCLUSIONS
  Recent treatment guidelines for breast cancer in Japan recommended risk-reducing salpingo-oophorectomy for BRCA1/2 mutation carriers. Risk-reducing salpingo-oophorectomy should be performed in the framework of the standard therapeutic modality for BRCA1/2 mutation carriers in the near future.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan. hir-aki@z8.keio.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Hirasawa
authors.forename: Kenta
authors.initials: K
authors.lastname: Masuda
authors.forename: Tomoko
authors.initials: T
authors.lastname: Akahane
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Tsuruta
authors.forename: Kouji
authors.initials: K
authors.lastname: Banno
authors.forename: Kazuya
authors.initials: K
authors.lastname: Makita
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Susumu
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Jinno
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Kokichi
authors.initials: K
authors.lastname: Sugano
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kosaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000328:Adult; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D061325:Hereditary Breast and Ovarian Cancer Syndrome / Q000235:genetics / Q000517:prevention & control; D006579:Heterozygote; D006801:Humans; D019458:Insurance Coverage; D007564:Japan; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy / Q000191:economics; D010375:Pedigree; D012307:Risk Factors; D040242:Risk Reduction Behavior; D058994:Salpingectomy / Q000191:economics
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human