More than 130 years of breast cancer surgery and clinical practice in China
10.3760/cma.j.cn112139-20250829-00421
- VernacularTitle:130余年乳腺癌外科发展回顾与中国临床实践
- Author:
Yinhua LIU
1
;
Ling XIN
1
;
Yixuan SONG
1
Author Information
1. 北京大学第一医院甲状腺乳腺外科，北京 100034
- Publication Type:Journal Article
- Keywords:
Breast diseases;
Breast Surgery;
Development history;
Chinese clincal practice
- From:
Chinese Journal of Surgery
2026;64(1):16-20
- CountryChina
- Language:Chinese
-
Abstract:
It has been 131 years since Halsted reported radical mastectomy to treat breast cancer in 1894. The concept of “R0 resection” as the most important treatment strategy has significantly contributed to improving the survival rate of patients with breast cancer. With deep understanding of the mechanism of tumorigenesis and advancements in systematic treatment since the 20th century,modified radical mastectomy proposed by Patey and Auchincloss,aimed to improve quality of life,replaced radical mastectomy and became the mainstream surgery for breast cancer. Based on NSABP-B06 trial,the 2025 St. Gallen consensus persisted in the principle of preserving breast-conserving surgery whenever possible. Additionally,the guidelines recommend axillary lymph node dissection can be omitted in patients with negative sentinel lymph nodes,supported by high-level evidence. The AJCC Cancer Staging System (8th Edition) showed the evaluation of breast cancer burden has transcended TNM stage,leading to the level of detecting microscopic tumor burden. Pathological test is no longer limited to pathomorphology, instead,immunohistochemistry,molecular pathology testing,and next-generation sequencing technologies have laid a scientific foundation for categorized treatment of breast cancer. The evolution of breast cancer surgery is undergoing a shift from “maximal resection” to “minimal effective treatment” de-escalation. On this basis,promoting the standardization and homogenization of breast surgery suited to China′s national conditions is the common goal of breast surgeons at this stage.
