{"created":"2023-06-19T10:43:11.857266+00:00","id":3370,"links":{},"metadata":{"_buckets":{"deposit":"9f915bab-9093-4f95-8d2f-d7c5afa0857e"},"_deposit":{"created_by":11,"id":"3370","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"3370"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00003370","sets":["6:7:222:223"]},"author_link":["696","408","268","406","7503","404","7502","218","365","774","561"],"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"トウイン ニ オケル イデンセイ ニュウガン シンリョウ ノ トリクミ ト ゲンキョウ : HBOC ノ シンリョウ タイセイ ト コンゴ ノ テンボウ ニ 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ガイドラインを基準とし，遺伝カウンセリングは研修を修了した乳腺専門医や認定遺伝カウンセラーが協力して担当することとしている．2018年には本邦でも転移・再発乳がんの一部に対しPARP阻害薬のコンパニオン診断としてBRCA1/2遺伝子検査が保険承認され，当院は遺伝カウンセリング加算の施設基準に係る届出を行なっている医療機関として，近隣の医療機関と連携し積極的にこれを支援している．乳腺診療の現場では遺伝性乳癌に対して自費診療と保険診療が混在しているが，BRCA1/2遺伝子検査としての内容に実質的な変わりはなく，結果の解釈や血縁者に与える影響に対しては専門的知識が要求される．当院におけるBRCA1/2遺伝子検査と遺伝カウンセリングの体制は，自費診療で培った体制を活かしながら，HBOC診療に有効に機能している．また，マルチプレックス遺伝子パネル検査の普及により，今後，二次的所見としてHBOC以外の稀な遺伝性乳癌への対応が増えることも予測される．遺伝医学に関わる多職種でのチーム医療として乳癌を含む遺伝性腫瘍の診療に取り組み，それぞれのリスクに応じた医学的管理体制の充実などが望まれている．","subitem_description_type":"Abstract"}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Departmental Bulletin 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