Editor's Note: Breast cancer is one of the most common malignancies among women, and while treatment methods continue to improve, maintaining patients' quality of life while extending their survival remains a key focus in the medical community. With the emergence of oncoplastic surgery (OPS) and fat grafting techniques, the post-operative quality of life for breast cancer patients has significantly improved. At the Sixteenth Shanghai Breast Reconstruction Conference, Oncology Frontier invited Dr. Guangyu Liu from Fudan University Shanghai Cancer Center to deeply explore the latest advancements, clinical applications, and future development trends in breast reconstruction techniques. Prof. Liu shared valuable experiences and insights on how OPS helps achieve better breast shape and function, the use of fat grafting in breast reconstruction, the timing and order of reconstruction surgery with adjuvant therapy, and the future trends in breast reconstruction.

01

Oncology Frontier: Can you introduce us to what oncoplastic surgery (OPS) is, and how it helps patients achieve better breast shape and function? What is the status of using OPS to increase breast-conserving rates in clinical practice in China?

Dr. Guangyu Liu: Oncoplastic surgery is a fusion of oncological surgery and plastic surgery techniques and is gradually gaining popularity in breast cancer treatment. OPS not only extends the survival of breast cancer patients but also significantly enhances their quality of life. Regardless of age, maintaining a pleasing breast contour can boost patients’ confidence in their treatment and future life.

Previously, breast-conserving oncoplastic surgery was limited to patients with smaller tumors. However, as the technique matured, it is now being applied to cases with relatively larger tumors, significant shape deformities, or unsatisfactory post-operative appearance. We can employ different treatment approaches to ensure a good breast contour, such as using adjacent flaps or remote flaps. With the increasing maturity of OPS techniques, its clinical application has expanded, leading more physicians who previously refrained from recommending breast conservation to now include it in their treatment recommendations.

02

Oncology Frontier: Could you share with us the application of fat grafting techniques in breast reconstruction?

Dr. Guangyu Liu: Currently, fat grafting for breast reconstruction is not yet widely practiced in our center; most of these procedures are conducted by plastic surgeons. This technique is quite specialized and has gained popularity in recent years abroad, while domestically, it is still in its infancy. At this year’s conference, we invited prominent plastic surgeons to perform demonstrations and provide detailed explanations, reflecting the belief that fat grafting will play an important complementary role in breast reconstruction and breast surgery. At present, it may not be the mainstream reconstruction method, but it serves as an excellent corrective option for patients with specific needs or who require secondary refinement following an initial reconstruction.

03

Oncology Frontier: How do you consider the timing and sequence of reconstruction surgery with adjuvant therapies (e.g., chemotherapy, radiotherapy) to ensure optimal outcomes and quality of life for patients?

Dr. Guangyu Liu: With advancements in reconstructive techniques and simplified methods, combined with the integration of systemic and adjuvant radiotherapy with surgery, we can ensure patients have opportunities for breast reconstruction or oncoplastic surgery without increasing complications, achieving the dual benefit of improved aesthetics and quality of life.

04

Oncology Frontier: Considering this conference and international developments, what do you see as the future trends in breast reconstruction techniques?

Dr. Guangyu Liu: Breast reconstruction is increasingly being recognized as a crucial field. In all breast cancer conferences, there are dedicated sections on breast reconstruction and aesthetic surgery, highlighting their significance in breast cancer treatment. For surgeons, it is crucial to include training in reconstruction and aesthetic techniques. The future of breast reconstruction will see these procedures becoming simpler and more accessible, while more complex surgeries will continue to address the diverse needs of different patients. This ensures not only prolonged survival but also a significantly enhanced quality of life and overall patient satisfaction.

Dr. Guangyu Liu

• Position: Chief Physician and Administrative Deputy Director, Breast Surgery, Fudan University Shanghai Cancer Center
• Leadership: Chairman of the Shanghai Association of Breast Cancer Committee
• Committee Memberships: Standing Member of the 9th Committee of the Breast Cancer Branch, Chinese Anti-Cancer Association
• Editorial Roles: Editorial Board Member for Chinese Journal of Metastatic Tumors, Chinese Journal of Endocrine Surgery, and Chinese Journal of Cancer.

Dr. Guangyu Liu is a distinguished expert committed to advancing breast reconstruction techniques in China, focusing on both the aesthetic and functional outcomes of breast cancer surgeries.