Editorial Note: Breast cancer poses a significant global challenge to women’s health. In China, unprecedented efforts are being made to advance standardized diagnosis and quality control in breast cancer care. During the 2024 Conference on Standardized Diagnosis and Quality Control in Breast Cancer, Oncology Frontier interviewed the conference chair, Dr. Fei Ma from the Cancer Hospital Chinese Academy of Medical Sciences . Professor Ma shed light on the core values and profound significance of quality control in breast cancer care, offering a clear direction for future advancements. In the interview, he shared the latest achievements, ongoing challenges, and the pivotal role of quality control in bridging gaps between urban and rural areas and promoting equitable access to high-quality medical resources. He emphasized that comprehensive quality control and the standardization of breast cancer care are critical steps toward achieving the Healthy China 2030 goals.

Oncology Frontier: As the chair of the conference, could you highlight the key takeaways and standout features of the 2024 Conference on Standardized Diagnosis and Quality Control in Breast Cancer?

Dr. Fei Ma: The 2024 Conference on Standardized Diagnosis and Quality Control in Breast Cancer was held in Beijing from November 8 to 10, in a hybrid online and offline format. Several highlights stood out this year:

1. Significant Progress in Quality Control: The pilot program for breast cancer quality control has yielded remarkable results and has now become a model for quality control in other common malignancies nationwide. At this conference, I presented the Report on China’s Standardized Diagnosis and Quality Control in Breast Cancer, which detailed these achievements. These efforts not only highlight the comprehensive progress of breast cancer quality control but also offer valuable insights for other malignancies.
2. Launch of the 2024 Edition of the Breast Cancer Quality Control Yearbook: This newly released yearbook documents the milestones in standardized breast cancer care, showcasing the collective efforts of Chinese scholars and society. It will continue to serve as a vital data resource for future breast cancer prevention and control.
3. Focus on Advanced Breast Cancer and Regional Disparities: The conference highlighted pressing issues, such as addressing advanced breast cancer challenges. The release of the 2024 Guidelines for Standardized Diagnosis and Treatment of Advanced Breast Cancer (ABCC 2024) aims to promote better care for patients with advanced disease, including those with complex conditions like brain metastases. Special attention was also given to patients from China’s western regions, including Tibet, Qinghai, Gansu, and Yunnan, where tumor characteristics differ due to high-altitude environments. Field studies were conducted in these areas, leading to the publication of the Consensus on Standardized Diagnosis and Prevention of Malignant Tumors in High-Altitude Areas in China. This consensus will guide efforts to enhance cancer care in these regions.
4. Prioritizing Patient-Centered Quality of Life: The conference emphasized preserving fertility in breast cancer patients, especially young women. Beyond curing the disease, we aim to protect their right to motherhood and ensure they can have healthy babies. Achieving this goal will require collaboration with reproductive medicine and other disciplines.

Additionally, significant attention was given to breast cancer research and its clinical translation. Progress in clinical care depends on advancements in scientific research, academic exchanges, and publications. We hope that the experiences and strategies developed by Chinese scholars in managing and preventing breast cancer can benefit the fight against other cancers worldwide, contributing to global cancer prevention and control efforts.

Oncology Frontier: Since 2019, the National Cancer Center (NCC) and the National Cancer Quality Control Center (NQCCC) have implemented quality control programs for single cancer types across China. Based on your experience, what is the importance of quality control in standardized breast cancer care? How does it address regional and urban-rural disparities?

Dr. Fei Ma: In 2016, China’s State Council released the Healthy China 2030 Plan Outline, laying out an ambitious blueprint with the goal of increasing the overall five-year cancer survival rate by 15%, reaching 46.6% by 2030. This is a challenging yet essential target. The NCC and NQCCC have been actively advancing cancer prevention and control nationwide to fulfill this vision.

Breast cancer, the first malignancy to undergo single-cancer quality control trials, underscores its significance. National surveys have identified several critical issues in breast cancer care:

• Survival Rate Gap: Compared to Western countries, China’s five-year survival rate for breast cancer remains lower. Addressing this gap requires focused efforts to improve care quality.
• Regional and Urban-Rural Disparities: Significant differences in survival rates exist between urban and rural areas, with rural patients faring worse. Bridging these gaps is an urgent priority.
• Resource Accessibility: Cancer prevention and control resources are not yet widely accessible in grassroots communities, underscoring the need to expand high-quality care to underserved areas.

The goal of standardized diagnosis and quality control is to address these challenges by enhancing the uniformity and quality of breast cancer care nationwide. Measures include developing and promoting comprehensive guidelines, refining quality control metrics, and improving access to medical resources at the community level.

Oncology Frontier: Breast cancer is the most common cancer among women globally and the first cancer type to pilot quality control programs in China. Could you share the latest progress and achievements in standardized breast cancer care and the challenges that lie ahead?

Dr. Fei Ma: Significant strides have been made in breast cancer quality control in recent years, despite challenges posed by the pandemic. Key achievements include:

1. Comprehensive Guidelines and Metrics: We have developed a full spectrum of guidelines covering screening, early diagnosis, treatment, medication use, advanced care, follow-up health management, and county-level diagnosis. A quality control metric system comprising 24 indicators was also introduced, covering the entire breast cancer care continuum. Some of these indicators have been integrated into the National Health Commission’s tumor quality control standards and are mandatory for hospitals nationwide. Additionally, five indicators have been included in the 2024 public hospital performance evaluation, solidifying their importance in national healthcare assessments.
2. Organizational and Technological Advances: A robust organizational structure, comprising a national committee and 23 provincial subcommittees, has been established to drive cancer quality control initiatives. For instance, regions like Tibet and Inner Mongolia have set up expert committees to advance local cancer prevention efforts.

On the technological front, we’ve leveraged the National Anti-Cancer Drug Monitoring Platform to create a breast cancer database encompassing over 2,000 healthcare institutions. This digital infrastructure enables real-time monitoring, supports scientific research, and facilitates data-driven decision-making.

1. Pilot Centers for Regional Excellence: The establishment of 200 pilot centers, with plans for another 200 in the future, will anchor breast cancer care at the municipal and county levels. This ensures that patients receive top-tier care locally without needing to travel to major cities.

Despite these advancements, challenges remain. We need to strengthen screening efforts, particularly by integrating maternal and child health services, traditional medicine, and preventive care systems. Collaboration across these domains is essential for a cohesive approach to cancer prevention. Additionally, improving patients’ quality of life beyond medical treatment, including health literacy and survivorship support, will remain a focal point of future efforts.

About Dr. Fei Ma

• Chief Physician, Professor, PhD Supervisor, and Distinguished Changjiang Scholar
• Director of the Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences
• Secretary General, National Expert Committee on Clinical Use of Anti-Cancer Drugs
• Deputy Chair, National Breast Cancer Quality Control Committee
• Secretary General, NCC Breast Cancer Screening and Early Diagnosis Committee
• Expert Consultant, Healthy China Action Initiative
• Deputy Chair, Chinese Association of Pharmacists’ Oncology Pharmacy Committee
• Deputy Chair, Integrative Cardio-Oncology Committee, Chinese Anti-Cancer Association
• Secretary General, Tumor Drug Clinical Research Committee, Chinese Anti-Cancer Association
• Deputy Chair, National Project for Ovarian Protection and Anti-Aging in Women
• Secretary General, Chinese Geriatric Oncology Society
• Vice Chair, Beijing Breast Disease Prevention Society
• Chair, Oncology Chemotherapy Quality Control Committee, Beijing Tumor Quality Control and Improvement Center
• Editor-in-Chief, Cancer Innovation
• Recipient of National Science and Technology Progress Award (Second Prize), Top 10 Outstanding Young Doctors in Beijing, and China Young Scientist Award in Oncology