Abstract
We examined the current status of clinical practice and awareness of hereditary, familial breast cancer in Japan. We conducted a questionnaire survey and received answers from 27 centers and 60 breast surgeons. Fifty two percent of centers have ever experienced the patients with suspected familial, hereditary breast cancer, but only 11% have performed the genetic test. One reason why genetic tests are rare is that there is no genetic counseling service in the center （82%）. Another reason for not being tested is that there is no consensus how to deal with hereditary breast cancer （78%）. If the genetic test turns out hereditary breast cancer, 89% centers introduce the families to genetic counseling. However, 97% conduct screening alone for women who are at a high risk for breast cancer. There is no surgeon to do either chemoprevention or prophylactic surgery for them. For the patients with hereditary breast cancer, 83 % perform breast conserving surgery as therapeutic operation, whereas only 5% think they will undergo contralateral prophylactic mastectomy. In current clinical practice, Japanese surgeon has not taken genetic testing and risk reduction surgery for hereditary, familial breast cancer. Japanese society should face to this issue and try to build consensus how to treat and the appropriate health care system.
