Objective: Rehabilitation therapy has been rapidly spreading in Japan in recent years, but the response to the recent outbreak of the new type of COVID-19 infection has affected the usual medical treatment at medical institutions. In this study, we investigated the progress and current status of rehabilitation treatment in terms of insurance payments.

Method: From 2015 to 2020, "rehabilitation fees for cardiovascular diseases, cerebrovascular diseases, disuse syndromes, musculoskeletal diseases, respiratory diseases, and cancer patients" were included in the statistics by social medical treatment practice published by the Ministry of Health, Labour and Welfare. The number of times the rehabilitation fee was calculated and the number of points for each rehabilitation fee and inpatient fee for convalescent rehabilitation wards, along with annual changes, were examined. We also examined the annual changes in the number of times rehabilitation fees were calculated for each disease by age group, and the annual changes in the number of times rehabilitation fees were calculated for each age group by inpatient and outpatient admission in 2019 and 2020.

Results: The number of rehabilitation fees increased from 2006 to 2018 but decreased from 2019. In 2020, the number of fees calculated for cardiovascular disease rehabilitation, musculoskeletal rehabilitation, and disuse syndrome rehabilitation decreased by 17.7%, 8.1%, and 4.9%, respectively, compared to the previous year.

Conclusion: Rehabilitation therapy was widespread until 2018, but it decreased significantly in 2020, which was considered to be due to the epidemic of COVID-19 infection.

Background: Contralateral risk-reduction mastectomy (CRRM) in patients with BRCA1/2 pathological variant-positive breast cancer was approved by national insurance in Japan in April 2020, however, pathological evaluation methods for CRRM specimens has not been standardized. In this study, we compared results from preoperative imaging and postoperative pathology to investigate latent breast cancer detection rates and the pathological evaluation method for CRRM specimens.

Methods: Seven cases of CRRM performed at our hospital from 2015 to 2020 were included in this study. For tissue retrieval, 10 mm whole slice, hematoxylin and eosin (H&E) stained CRRM specimens were used. We also evaluated p53 and Ki-67 immunohistochemical staining.

Results: H&E staining of CRRM specimens showed intraductal proliferative lesions in one patient and fibroadenoma in another, but no invasive carcinoma, noninvasive ductal carcinoma, or precancerous lesions were found in all sections in all seven patients. Our p53 and Ki-67 immunohistochemistry results did not significantly differ between patients, with or without BRCA1/2 pathological variants. Our p53 and Ki-67 immunohistochemistry results showed no significant difference between patients with or without BRCA1/2 pathological variants.

Conclusion: In this study, no latent breast cancer was identified during the pathological evaluation of split CRRM specimens. Our results indicate the importance of performing high-quality imaging evaluations, and support the simplification of the pathological evaluation method for CRRM specimens.