Implementation of risk-reducing surgery for HBOC under public insurance in Japan: a single-center experience

6.5 months for RRM and 11.3 months for RRSO.Importantly, RRSO was significantly delayed among BRCA2 carriers compared with BRCA1 carriers (15.2 vs. 6.4 months, p = 0.02).The only three women who have continued to defer RRSO did so due to fertility considerations.Before insurance coverage, only one or two RRSO procedures were performed annually, and RRM was rare because costs exceeded JPY 1,000,000, including reconstruction.Public insurance thus played a pivotal role in expanding access to both procedures [1,2].The observed delays among BRCA2 carriers likely reflect later ovarian cancer onset and fertility considerations [3].These findings highlight the importance of individualized counseling that considers age, reproductive planning, and gene-specific risk, and multicenter studies are warranted to confirm whether our single-center experience reflects national trends.