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In Japan, risk-reducing salpingo-oophorectomy (RRSO), which is now covered by insurance, is rapidly increasing for breast cancer patients with BRCA1/2 germline mutation. In this chapter, we first review new findings from recent clinical trials on RRSO for the prevention of breast, ovarian, fallopian tube, and peritoneal cancers. Next, we discuss measures to address recent issues in clinical practice regarding the preventive treatment of secondary cancers in breast cancer patients, especially in elderly patients. Specifically, these are the following questions. (1) Should RRSO be aggressively performed on breast cancer patients? (2) Does RRSO reduce the risk of breast cancer recurrence and the risk of developing secondary breast cancer? (3) Do anticancer drugs used in the treatment of breast cancer decrease the risk of developing ovarian cancer? Finally, the results of the analysis of the Japan Organization of Hereditary Breast and Ovarian Cancer (JOHBOC) national registry will be presented, detailing the differences in cancer risk by gene, particularly in age at onset. Based on the data, we discuss how information on risk-reducing surgery should be provided in genetic counseling for breast cancer patients.

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RRSO for Aged Patients with Breast Cancer

  • 章节

  • 发表日期：

    2025年

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  • Masayuki Sekine,
  • Rie Nakamura,
  • Tomoko Nakamoto,
  • Yukiko Chinen,
  • Yoshino Kinjo,
  • Natsuki Tamashiro,
  • Yuko Shimoji,
  • Yusuke Taira,
  • Yoshihisa Arakaki,
  • Takuma Oyama,
  • Wataru Kudaka

摘要

In Japan, risk-reducing salpingo-oophorectomy (RRSO), which is now covered by insurance, is rapidly increasing for breast cancer patients with BRCA1/2 germline mutation. In this chapter, we first review new findings from recent clinical trials on RRSO for the prevention of breast, ovarian, fallopian tube, and peritoneal cancers. Next, we discuss measures to address recent issues in clinical practice regarding the preventive treatment of secondary cancers in breast cancer patients, especially in elderly patients. Specifically, these are the following questions. (1) Should RRSO be aggressively performed on breast cancer patients? (2) Does RRSO reduce the risk of breast cancer recurrence and the risk of developing secondary breast cancer? (3) Do anticancer drugs used in the treatment of breast cancer decrease the risk of developing ovarian cancer? Finally, the results of the analysis of the Japan Organization of Hereditary Breast and Ovarian Cancer (JOHBOC) national registry will be presented, detailing the differences in cancer risk by gene, particularly in age at onset. Based on the data, we discuss how information on risk-reducing surgery should be provided in genetic counseling for breast cancer patients.