{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T09:51:17Z","timestamp":1781949077839,"version":"3.54.5"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012781","name":"Merck Sharp and Dohme K.K.","doi-asserted-by":"publisher","award":["Merck Sharp and Dohme K.K."],"award-info":[{"award-number":["Merck Sharp and Dohme K.K."]}],"id":[{"id":"10.13039\/100012781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020869","name":"AstraZeneca KK","doi-asserted-by":"publisher","award":["AstraZeneca KK"],"award-info":[{"award-number":["AstraZeneca KK"]}],"id":[{"id":"10.13039\/100020869","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Adjuvant olaparib significantly improves invasive disease-free and overall survival in high-risk human epidermal growth factor receptor 2 (HER2)-negative, early breast cancer patients carrying germline breast cancer susceptibility gene 1\/2 (\n                      <jats:italic>gBRCA<\/jats:italic>\n                      ) pathogenic variants (PVs). Timely\n                      <jats:italic>gBRCA<\/jats:italic>\n                      testing as a companion diagnostic for adjuvant olaparib is essential. However, its real-world uptake remains unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We enrolled patients with invasive HER2-negative early breast cancer who underwent curative surgery during 2023 in Japan. Eligibility was based on the OlympiA trial criteria. Estrogen receptor (ER)-positive patients required\u2009\u2265\u20094 positive nodes after surgery or non-pathological complete response (non-pCR) with clinical and pathologic stage (CPS) and estrogen receptor status and histologic grade (EG) score\u2009\u2265\u20093 following neoadjuvant chemotherapy (NAC). ER-negative patients required invasive tumor\u2009&gt;\u20092\u00a0cm or \u2265\u20091 nodal metastasis after surgery, or non-pCR after NAC. The primary outcome was\n                      <jats:italic>gBRCA<\/jats:italic>\n                      testing rate; secondary outcomes included a proportion of patients with\n                      <jats:italic>gBRCA<\/jats:italic>\n                      PVs and a proportion of patients starting adjuvant olaparib. We also explored factors associated with not undergoing testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 824 patients enrolled from 46 facilities, 691 were analyzed after random sampling and exclusions. The testing rate was 63.2% (95% confidence interval 59.5\u201366.9). Among 254 untested patients, 168 (66%) were not informed\u2014mainly due to physician oversight in recognizing eligibility (57%) or physician-perceived patient ineligibility (40%). Of 69 informed but untested patients, reasons included psychological distress (46%), testing cost (35%), and familial concerns (12%). Of 42 patients (9.6%) with\n                      <jats:italic>gBRCA<\/jats:italic>\n                      PVs, 32 received olaparib. Multivariable analysis (female only) showed that age\u2009\u2265\u200965 years, postmenopausal status, major comorbidities, upfront surgery, absence of family history of hereditary breast and ovarian cancer-related cancers, and absence of bilateral or multiple primary breast cancers were associated with lower testing rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Greater physician awareness of companion diagnostic is needed to ensure timely\n                      <jats:italic>gBRCA<\/jats:italic>\n                      testing and equitable access to adjuvant olaparib.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12282-026-01867-y","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T06:25:59Z","timestamp":1779517559000},"page":"919-927","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world uptake of gBRCA testing as a companion diagnostic for olaparib in patients with high-risk HER2-negative early breast cancer in Japan: a cross-sectional multicenter study (BRCAwareness)"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1309-2763","authenticated-orcid":false,"given":"Tomoe","family":"Taji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Seki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Takabatake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Harao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Nakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Matsunuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinatsu","family":"Koganezawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Iwamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Mukai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Kikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"issue":"2","key":"1867_CR1","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s12282-025-01671-0","volume":"32","author":"M Nagahashi","year":"2025","unstructured":"Nagahashi M, Kumamaru H, Kinukawa N, et al. Breast cancer statistics for Japan in 2022: Annual Report of the National Clinical Database-Breast Cancer Registry\u2014Clinical Implications including chemosensitivity of breast cancer with low estrogen receptor expression. Breast Cancer. 2025;32(2):217\u201326. https:\/\/doi.org\/10.1007\/s12282-025-01671-0.","journal-title":"Breast Cancer"},{"issue":"1","key":"1867_CR2","doi-asserted-by":"publisher","first-page":"4083","DOI":"10.1038\/s41467-018-06581-8","volume":"9","author":"Y Momozawa","year":"2018","unstructured":"Momozawa Y, Iwasaki Y, Parsons MT, et al. Germline pathogenic variants of 11 breast cancer genes in 7051 Japanese patients and 11,241 controls. Nat Commun. 2018;9(1):4083. https:\/\/doi.org\/10.1038\/s41467-018-06581-8.","journal-title":"Nat Commun"},{"issue":"25","key":"1867_CR3","doi-asserted-by":"publisher","first-page":"2394","DOI":"10.1056\/nejmoa2105215","volume":"384","author":"ANJ Tutt","year":"2021","unstructured":"Tutt ANJ, Garber JE, Kaufman B, et al. Adjuvant Olaparib for patients with BRCA1- or BRCA2-mutated breast cancer. N Engl J Med. 2021;384(25):2394\u2013405. https:\/\/doi.org\/10.1056\/nejmoa2105215.","journal-title":"N Engl J Med"},{"issue":"12","key":"1867_CR4","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1016\/J.ANNONC.2022.09.159","volume":"33","author":"CE Geyer","year":"2022","unstructured":"Geyer CE, Garber JE, Gelber RD, et al. Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1\/2 and high-risk, early breast cancer. Ann Oncol. 2022;33(12):1250\u201368. https:\/\/doi.org\/10.1016\/J.ANNONC.2022.09.159.","journal-title":"Ann Oncol"},{"key":"1867_CR5","doi-asserted-by":"publisher","unstructured":"Ladoire S, Mamguem Kamga A, Galland L, et al. Real-world prevalence, treatment and survival of \" high risk\" early breast cancer, with mandatory testing of gBRCA1\/2 mutation according to the OlympiA trial inclusion criteria: data from a population-based registry. Breast. 2024;78. https:\/\/doi.org\/10.1016\/j.breast.2024.103789","DOI":"10.1016\/j.breast.2024.103789"},{"issue":"15","key":"1867_CR6","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3390\/cancers15153847","volume":"15","author":"D Dannehl","year":"2023","unstructured":"Dannehl D, Engler T, Volmer LL, et al. Which patients do we need to test for BRCA1\/2 mutation? Feasibility of adjuvant olaparib treatment in early breast cancer\u2013Real-World Data from two large german breast centers. Cancers (Basel). 2023;15(15):4\u201313. https:\/\/doi.org\/10.3390\/cancers15153847.","journal-title":"Cancers (Basel)"},{"issue":"6","key":"1867_CR7","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1001\/jamaoncol.2015.5941","volume":"2","author":"SM Rosenberg","year":"2016","unstructured":"Rosenberg SM, Ruddy KJ, Tamimi RM, et al. BRCA1 and BRCA2 mutation testing in young women with breast cancer. JAMA Oncol. 2016;2(6):730\u20136. https:\/\/doi.org\/10.1001\/jamaoncol.2015.5941.","journal-title":"JAMA Oncol"},{"key":"1867_CR8","doi-asserted-by":"publisher","unstructured":"Mishkin K, Li Q, Earla JR, et al. Factors influencing patient preferences for BRCA testing and adjuvant therapy in HER2-negative early breast cancer in the United States: best\u2013worst scaling and discrete choice experiment. Patient. 2025. https:\/\/doi.org\/10.1007\/s40271-025-00783-1.","DOI":"10.1007\/s40271-025-00783-1"},{"key":"1867_CR9","doi-asserted-by":"publisher","unstructured":"Yadav S, Couch FJ, Hillman S, et al. Real-world germline BRCA testing, Poly(ADP-ribose) polymerase inhibitor utilization, and survival outcomes in human epidermal growth factor receptor 2\u2013negative metastatic breast cancer. JCO Precis Oncol. 2025; (9):99\u201311. https:\/\/doi.org\/10.1200\/po-24-00814","DOI":"10.1200\/po-24-00814"},{"issue":"2","key":"1867_CR10","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s12282-022-01424-3","volume":"30","author":"T Taji","year":"2023","unstructured":"Taji T, Odan N, Kataoka Y, et al. Promoters of BRCA testing under insurance coverage for non-metastatic breast cancer patients in Japan: a retrospective cohort study. Breast Cancer. 2023;30(2):309\u201314. https:\/\/doi.org\/10.1007\/s12282-022-01424-3.","journal-title":"Breast Cancer"},{"key":"1867_CR11","doi-asserted-by":"publisher","first-page":"543","DOI":"10.2147\/CLEP.S206949","volume":"11","author":"N Armstrong","year":"2019","unstructured":"Armstrong N, Ryder S, Forbes C, et al. A systematic review of the international prevalence of BRCA mutation in breast cancer. Clin Epidemiol. 2019;11:543\u201361. . https:\/\/doi.org\/10.2147\/CLEP.S206949","journal-title":"Clin Epidemiol"}],"container-title":["Breast Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12282-026-01867-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12282-026-01867-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12282-026-01867-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T09:22:21Z","timestamp":1781947341000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12282-026-01867-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["1867"],"URL":"https:\/\/doi.org\/10.1007\/s12282-026-01867-y","relation":{},"ISSN":["1340-6868","1880-4233"],"issn-type":[{"value":"1340-6868","type":"print"},{"value":"1880-4233","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]},"assertion":[{"value":"24 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"TT has received lecture fees from Chugai Pharmaceutical and Devicor Medical Products and is the principal investigator of CSPOR-BC, which has received institutional research funding from AstraZeneca; however, TT has not received any personal financial compensation from AstraZeneca. YK and SN have received consulting fees from Daiichi Sankyo. YU has received consulting fees from Amgen. NM has received lecture fees from Daiichi Sankyo, Eli Lilly, Gilead Sciences, and Chugai Pharmaceutical. AI has received lecture fees from Eli Lilly. HS has received lecture fees from Daiichi Sankyo, Eli Lilly, Chugai Pharmaceutical, AstraZeneca, Eisai, Pfizer, and MSD. DT has received lecture fees from Daiichi Sankyo, Eli Lilly, Chugai Pharmaceutical, AstraZeneca, Pfizer, Gilead Sciences, and MSD. MH has received lecture fees from Daiichi Sankyo, Eli Lilly, Chugai Pharmaceutical, AstraZeneca, Pfizer, Gilead Sciences, and MSD. SN has received lecture fees from Chugai Pharmaceutical, Eisai, and Pfizer. CK has received lecture fees from MSD and Pfizer. TI has received lecture fees from Daiichi Sankyo, Eli Lilly, Chugai Pharmaceutical, Takeda, AstraZeneca, MSD, Eisai, and Kyowa Kirin. HM has received lecture fees from Takeda and Taiho Pharmaceutical. YK has received lecture fees from Daiichi Sankyo, Eli Lilly, Chugai Pharmaceutical, AstraZeneca, Eisai, and Pfizer. All other authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"During the preparation of this work, the authors used ChatGPT (OpenAI, USA) in order to improve language and readability (English language editing and proofreading). After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Generative AI and AI-assisted technologies in the manuscript preparation process"}}]}}