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

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 salpingooophorectomy 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 riskreducing salpingo-oophorectomy for BRCA1/2 mutation carriers. Risk-reducing salpingooophorectomy should be performed in the framework of the standard therapeutic modality for BRCA1/2 mutation carriers in the near future.