Editor’s Note: From August 27–31, 2025, the 16th Yan Zhao Breast Cancer Forum was held grandly in Shijiazhuang. The event was jointly organized by the Breast Cancer Committee of the Hebei Anti-Cancer Association and several other specialty committees, co-organized by the Beijing Breast Disease Prevention and Treatment Society, and hosted by the Fourth Hospital of Hebei Medical University and the Hebei Breast Disease Diagnosis and Treatment Center. This year’s forum focused on multidisciplinary innovations and cutting-edge concepts in breast cancer management, aiming to advance standardized care and elevate regional treatment standards. At the meeting, Oncology Frontier invited the conference chair, Professor Yunjiang Liu of the Fourth Hospital of Hebei Medical University, for an in-depth interview. He discussed the core principles of oncoplastic surgery (OPS) in breast-conserving surgery, shared clinical experience and outcomes from the multidisciplinary team (MDT) model, and offered forward-looking perspectives on promoting greater uniformity in breast cancer care across the region and nationwide.OPS: Restoring Form While Ensuring Oncological Safety
Oncology Frontier: At this forum, you presented OPS and other innovative techniques. Could you explain the key operative principles using examples from the live surgery sessions? What do you see as the main challenges in promoting OPS?
Professor Yunjiang Liu: The 16th Yan Zhao Breast Cancer Forum opened on Wednesday. The first two days focused on live surgery demonstrations and technical exchanges among surgeons from across China. A major topic was OPS, encompassing oncoplastic breast-conserving surgery and reconstruction—both central directions for breast surgery development.
Many breast cancer patients, after diagnosis, face tremendous psychological pressure. They often believe “the more extensive the resection, the safer it is.” Yet, abundant evidence shows that for eligible patients, breast-conserving surgery achieves long-term outcomes equivalent to mastectomy, and in some cases even superior. Promoting breast-conservation and reconstruction therefore carries great significance. Internationally, breast-conserving rates reach 50%–70%, while in China they remain below 20%. Although awareness of oncoplastic principles has improved uptake in recent years, regional disparities in medical standards mean the national average for breast-conservation and reconstruction remains relatively low.
At our Breast Center, which serves as both a teaching hospital and cancer specialty hospital, we perform roughly 3,600 breast cancer surgeries annually. More than 40% are breast-conserving procedures. For patients not suitable for conservation, we actively pursue reconstruction, which reached a rate of about 19% in 2024. Overall, nearly 60% of our patients retain breast appearance after treatment here. Preserving breast form while ensuring effective oncologic treatment can profoundly improve patients’ family life, social participation, and psychological well-being.
This underscores the importance of OPS. Surgeons must not only ensure oncological safety—complete resection and clear margins—but also employ reconstructive techniques to restore breast contour. Compared with traditional breast-conserving surgery, OPS allows removal of a wider margin while using techniques such as tissue rearrangement or replacement (local flaps, distant flaps, pedicled or vascularized flaps) to achieve superior cosmetic results. For those not suitable for conservation, immediate reconstruction after mastectomy can still provide an excellent aesthetic outcome.
In recent years, we have actively promoted OPS. Our experts have participated in drafting national breast cancer treatment guidelines and conducting nationwide lectures. Within Hebei, we run annual “Surgical Miracles” training courses to spread OPS expertise. These efforts have steadily increased OPS cases in our province and expanded the pool of young surgeons skilled in this approach.
It is important to stress: OPS is not a single fixed technique but an individualized strategy. Each patient’s disease status and surgical defect require tailored solutions. At our center, we have mastered the full spectrum of OPS methods and remain committed to nationwide dissemination, with the ultimate goal of improving quality of life and enabling more breast cancer patients to embrace a better future.
MDT: Integrating Multidisciplinary Wisdom into Personalized Care
Oncology Frontier: As conference chair and a leading authority in Hebei’s breast cancer field, could you describe the advantages of your MDT model in clinical practice? What is its significance for improving regional care standards?
Professor Yunjiang Liu: The MDT model represents a milestone in the evolution from experiential medicine to evidence-based medicine, and now toward precision medicine. Experiential medicine relies on individual physicians’ judgment. Evidence-based medicine emphasizes clinical decisions grounded in large, prospective studies. Precision medicine goes further, tailoring strategies through deep analysis of each patient’s disease characteristics.
In today’s era of information explosion, no single physician can master all relevant knowledge. Breast cancer management spans surgery, neoadjuvant and adjuvant chemotherapy, endocrine therapy, targeted therapy, immunotherapy, and—after recurrence or metastasis—the management of complications such as bone fractures, spinal cord compression, brain edema, herniation, or organ dysfunction, as well as treatment-related adverse effects. The complexity of these scenarios makes multidisciplinary collaboration indispensable.
The MDT model originated at the Mayo Clinic in the 1980s and was introduced to China in the 1990s. Since the 2000s, it has been strongly promoted by the National Health Commission. Our hospital implemented MDT many years ago, through outpatient and inpatient case discussions, inter-hospital collaborations, and online meetings. A standardized MDT requires three essentials: fixed time, fixed place, and fixed participants with broad expertise; focus on critical decision points such as initial diagnosis, post-surgical pathology-based planning, and recurrence/metastasis management; and robust support from institutional infrastructure and health policy.
At our Breast Center, MDT has been in place for years and has yielded remarkable outcomes. We conduct 2–3 preoperative MDT meetings weekly and one postoperative recurrence/metastasis MDT. Preoperative MDT helps determine whether a patient is suitable for breast conservation, OPS, or mastectomy with reconstruction, thereby avoiding one-sided decisions by a single specialty. As a result, our rates of breast conservation and reconstruction have risen significantly, with about 60% of patients retaining breast form and function. For recurrent or metastatic disease, MDT ensures optimal, timely strategies, markedly improving treatment effectiveness. This model harnesses collective expertise, combines precision testing with evidence-based strategies, and tailors individualized, effective treatment plans for patients.
Building a Unified Quality Control System for Hebei Province
Oncology Frontier: China still faces uneven regional development in breast cancer care. How do you envision establishing a province-wide quality control system to promote uniform standards?
Professor Yunjiang Liu: Quality control is vital in disease management, and its essence lies in unified standards. The National Cancer Center has long established quality control committees, including a Breast Cancer Quality Control Committee where I serve as an expert member. The committee defines key quality indicators—streamlined from 26 to around 21–22 indicators—endorsed by the National Health Commission to comprehensively monitor breast cancer care. Yet, due to China’s vast geography and varied resources, some institutions struggle to fully implement them, resulting in non-uniform standards.
To address this, several measures are needed:
- Establish a provincial quality control expert team to define province-specific indicators, conduct inspections, and elevate overall standards.
- Promote clinical guidelines, such as the CSCO BC Guidelines, CBCS Guidelines, and series produced by the Breast Surgery Group of the Chinese Medical Association, to unify clinical pathways.
- Strengthen continuing education and training for community physicians, ensuring they adopt the latest evidence and techniques.
- Develop young surgeons’ skills in OPS, reconstruction, minimally invasive and robotic surgery, sentinel lymph node biopsy, and related techniques.
- Expand the MDT model to deliver individualized treatment plans and optimize outcomes.
- Enhance public cancer education to improve health literacy, screening awareness, and early detection, thereby reducing disease burden and conserving healthcare resources.
Thanks to these efforts, breast cancer care in Hebei has advanced significantly, aligning with international standards. Municipal hospitals in our province have won multiple awards in national case and surgical video competitions. Looking ahead, with sustained guideline dissemination and technical support, I am confident we will achieve province-wide and even nationwide uniformity in breast cancer management, contributing to the Healthy China 2030 goal of raising the five-year cancer survival rate by 15%.
Professor Yunjiang Liu
PhD, Professor (Second-Level), Doctoral Supervisor Fourth Hospital of Hebei Medical University
