Editor's Note: From October 15-17, 2024, the 16th Shanghai Breast Reconstruction Conference and 5th Shanghai Breast Reconstruction Nursing Forum were successfully held, organized by the Chinese Anti-Cancer Association's Breast Cancer Integration Committee and the Shanghai Anti-Cancer Association and hosted by Fudan University Shanghai Cancer Center. The conference focused on the status of breast conservation and reconstruction in China, promoting international exchanges and expanding achievements in breast reconstruction to preserve health and beauty for breast cancer patients. During the conference, Oncology Frontier interviewed the conference chairman, Dr. Jiong Wu from Fudan University Shanghai Cancer Center, to explore the current and future trends in breast conservation, reconstruction, and the latest advances in neoadjuvant immunotherapy in breast cancer treatment.

01

Oncology Frontier: The international component of this year’s Shanghai Breast Reconstruction Conference is quite strong, and you were also invited to give a keynote report at the International Surgical Week (ISW). Can you discuss the current development status and future trends in breast reconstruction and how we should improve technology through domestic and international exchanges?

Dr. Jiong Wu: Over the past decade, the level of surgical treatment for breast cancer and capacity building in China has made significant progress, with various techniques for breast reconstruction becoming more refined. Currently, implant reconstruction, autologous tissue reconstruction, or a combination of both have become the primary methods.

In implant reconstruction, the variety of implants and mesh types has increased significantly. Breast surgeons have also mastered skin-sparing and nipple-sparing mastectomy techniques, as well as techniques for breast skin reduction and reshaping. Consequently, the effectiveness of implant-based reconstruction in China has improved markedly. With multidisciplinary participation, many specialized breast surgeons, following good training, have ventured into microsurgical flap techniques to perform complex breast reconstructions.

Apart from full mastectomy and reconstruction, it’s essential to emphasize that most early-stage breast cancer cases can undergo breast-conserving surgery. Breast conservation remains an important and prioritized choice, and reconstructive techniques can help patients retain aesthetically natural breast contours. Over the past decade, a series of academic exchanges and specialized training sessions have significantly enhanced our specialized capabilities in breast surgery.

02

Oncology Frontier: Your team recently published a study on neoadjuvant therapy for triple-negative breast cancer (TNBC) in The Lancet sub-journal, focusing on the NeoTENNIS study. Can you share your thoughts on neoadjuvant therapy in breast cancer, based on these findings?

Dr. Jiong Wu: Systemic therapy has proven very effective for triple-negative breast cancer. Currently, the pathological complete response (pCR) rate for chemotherapy combined with immunotherapy can reach or exceed 60%. When we initiated the NeoTENNIS study, immunotherapy had not yet been approved for breast cancer-related indications, so we designed it as a phase II exploratory study. In this study, we used anthracyclines as an immune induction to theoretically convert “cold” tumors into “hot” tumors before sequentially administering nab-paclitaxel combined with a PD-1 inhibitor, achieving a pCR of 55.7%. The study enrolled 70 patients, with 62.9% being stage III and 93.9% having lymph node metastases. Despite the high tumor burden, this combined immunotherapy regimen demonstrated significant clinical efficacy, indicating promising results for this patient population.

03

Oncology Frontier: Breast reconstruction surgery remains relatively low in proportion domestically. What contributions has the Shanghai Breast Reconstruction Conference made to promote breast reconstruction surgery? How can we further advance post-operative breast reconstruction techniques?

Dr. Jiong Wu: The Shanghai Breast Reconstruction Conference, now in its 16th edition, is one of the oldest conferences of its kind. As organizers and participants, we have deeply felt the benefits of academic exchanges, technical sharing, and concept development in advancing our work on breast reconstruction.

At this conference, we invited top international experts in plastic surgery, such as Professor Phillip Blondeel and Professor Yu Peirong, who have made pioneering contributions to free flap breast reconstruction. Through their lectures and live surgical demonstrations, they shared cutting-edge concepts and techniques, allowing attendees to experience firsthand that there is always more to learn. Overall, as breast specialists, we need more opportunities to exchange with high-level colleagues at home and abroad and more specialized training to further improve our capabilities.

Dr. Jiong Wu

• Position: Executive Vice President, Fudan University Shanghai Cancer Center; Chief Physician and Doctoral Supervisor

• Role: Director of the Drug Clinical Trial Center, Fudan University Shanghai Cancer Center

• Leadership: Executive Director of the Breast Cancer Integration Committee, Chinese Anti-Cancer Association

• Previous Titles: Ninth Chairman of the Breast Cancer Committee, Chinese Anti-Cancer Association; Deputy Chairman of the Breast Surgery Committee, Chinese Medical Doctor Association

• Honorary Titles: Vice-Chairman of the Oncology Division, Chinese Medical Doctor Association; Standing Committee Member of the Oncology Society, Chinese Medical Association; Honorary Chairman of the Breast Cancer Branch, Shanghai Anti-Cancer Association.

Prof. Wu is a distinguished expert leading advancements in breast cancer surgery, breast conservation, and reconstruction, actively promoting the integration of academic knowledge and practical experience to improve the lives of breast cancer patients.