In 2020, BRCA1/2 genetic testing became covered by insurance in Japan for breast and ovarian cancer patients suspected of having hereditary breast and ovarian cancer (HBOC). At the same time, risk-reducing surgery also became available under insurance, leading to growing interest and expectations in genetic medicine. The Japanese Organization of Hereditary Breast and Ovarian Cancer (JOHBOC) operates a registry of HBOC patients and their families. The purpose of building the HBOC database is to clarify the genetic characteristics of Japanese individuals and to establish standard treatment practices. Participation is being encouraged from medical facilities throughout Japan. This chapter summarizes the 2023 data. A total of 161 facilities nationwide took part in the registry project. The number of enrolled BRCA1/2 pathogenic variant carriers was 4345. In addition, 451 patients underwent risk-reducing mastectomy (RRM), and 846 patients underwent risk-reducing salpingo-oophorectomy (RRSO). Since April 2020, surveillance, RRM, and RRSO for HBOC patients with a history of breast or ovarian cancer have been covered by insurance in Japan. Three years have passed since then, and the current state of HBOC care in Japan has gradually become clearer. However, HBOC care is still not covered by insurance for unaffected BRCA1/2 pathogenic variant carriers. Nearly 500 such unaffected carriers have already been enrolled in this registry. Developing a medical care system for these individuals is now considered an urgent priority.