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Background: In Japan, genetic testing, surveillance, and risk-reducing surgery for hereditary breast and ovarian cancer (HBOC) syndrome have been covered by the Japanese national insurance system since April 2020. On the other hand, the current situation is that medical care, including surveillance of undiagnosed (cancer-free) patients, is self-funded even for individuals with HBOC. We report a case in which breast cancer was diagnosed at an early stage during surveillance for cancer-free HBOC at the patient's own expense, and risk-reducing surgery was performed at the same time as treatment for breast cancer. Case presentation: The patient was a 63-year-old woman. Her sister had a history of breast cancer in her 30s and was found to be a BRCA2 pathogenic variant carrier by genetic testing. The patient therefore presented to the genetic department of our hospital and underwent genetic testing (out-of-pocket). A pathogenic variant was found at the same site. During annual breast and ovarian surveillance at the patient’s own expense, the physician with sufficient expertise in contrast-enhanced breast magnetic resonance imaging (MRI) noticed a change in the contrast enhancement pattern on breast MRI and performed needle biopsy, revealing ductal carcinoma in situ. At her request, she underwent concurrent contralateral risk-reducing mastectomy and risk-reducing salpingo-oophorectomy in addition to breast cancer treatment. Conclusions: We have seen a case in which cancer treatment and risk-reducing surgery were performed at the same time for a pathogenic variant carrier who was very anxious about developing cancer. Surveillance of cancer-free BRCA1/2 mutation carriers and expansion of insurance coverage for surgery are important future issues.

The synthetic detergent industry is one of the fastest growing industries in Japan. Its production, together with soap, is estimated to be almost 2 billion pounds in 1970. In addition to this increased production, quality modification in terms of biodegradability is now being undertaken. Alpha olefin sulfonate (AOS) has been known since the 1930's, but only within the last two years has it been highlighted for commercial interest as a detergent material due to progress in sulfonation technology as well as commercial availability of alpha olefins. To make use of AOS as an active ingredient for formulation of heavy duty household granules, several properties of AOS itself or of the built detergent were studied in comparison with linear alkylate sulfonate (LAS), alkylbenzene sulfonate (ABS) and alcohol sulfate (AS). AOS was proved to be a potentially economical detergent material having as good performance and better biological properties than LAS or AS and better biodegradability than LAS. It has been marketed since 1967 in Japan as the first AOS‐based household heavy duty granular detergent. It has been accepted by the housewives as the most efficient detergent and has become the best selling brand.

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