Current status of breast reconstruction in China: an experience of 951 breast reconstructions from a single institute.
BACKGROUND
Since mastectomy remained the primary strategy for treating breast cancer in China, post-mastectomy reconstruction is of great importance in the Chinese population. The current study aimed to assess the current status of breast reconstruction in China.


METHODS
We reviewed all patients who received breast reconstruction from August 2000 to July 2015 in the Department of Breast Surgery in our institute. Patients' baseline characteristics, reconstruction strategy, final pathology and loco-regional recurrence (LRR) information were collected.


RESULTS
A total of 951 breast reconstructions were conducted during the past 15 years, among which 247 (27.0%) were abdominal flap reconstruction; 471 (51.5%) were latissimus dorsi myocutaneous ± implant; and 233 (25.5%) were prosthesis-based reconstruction. The majority of cases (78.1%) were invasive breast cancer and up to 894 cases (94.0%) were immediate reconstruction. Prosthesis-based reconstruction rapidly increased in recent years, and was associated with bilateral reconstruction, contralateral augmentation and higher complications. 18 patients (2.0%) developed local-regional recurrence at the median follow-up time of 26.6 months (range, 3.7-62.0 months). A total of 66 nipple-areolar complex-sparing mastectomies (NSMs) (6.9%) were performed, none of which developed recurrence.


CONCLUSIONS
Breast reconstruction cases increased over the 15 years with the change of paradigm. Most strikingly, prosthesis-based reconstruction rapidly gained its prevalence and became the most common strategy. NSM was only performed for highly selected patients. Patients with breast reconstruction were able to achieve satisfactory loco-regional control in our cohort.
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Nai-Si
NS
Huang
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Chen-Lian
CL
Quan
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Lin-Xiao-Xi
LX
Ma
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Jing
J
Si
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Jia-Jian
JJ
Chen
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Ben-Long
BL
Yang
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Xiao-Yan
XY
Huang
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Guang-Yu
GY
Liu
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Zhen-Zhou
ZZ
Shen
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Zhi-Min
ZM
Shao
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Jiong
J
Wu
Breast reconstruction; China; breast cancer; current status