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The introduction "2021 Annual Progress Review of Breast Cancer Treatment" was held on January 8, 2022, mainly in the form of an online conference
.
This conference focuses on the important progress in the field of international and domestic breast cancer in 2021, and invites well-known experts and scholars in the field of breast cancer to give keynote speeches on the progress of translational research, surgical treatment, radiotherapy, early breast cancer and advanced breast cancer treatment.
A review summarizing important findings that have changed clinical practice in breast cancer
.
During the meeting, Yimaitong had the honor to interview Professor Liu Yinhua of Peking University First Hospital to share with us the research progress of breast surgery and neoadjuvant therapy
.
Professor Liu Yinhua Chief Physician, Professor, Doctor of Medicine, Doctoral Supervisor Chief Physician of Peking University First Hospital Chief Physician of the Chinese Medical Association Surgery Branch Head of the Breast Surgery Group of the Chinese Medical Association Surgery Branch Vice Chairman of the Beijing Medical Association Surgery Branch Beijing Medical Association In 2021, Yimaitong, deputy director of the Breast Disease Branch, will produce frequent research results in the field of breast cancer, which will drive changes in clinical practice.
What breakthroughs has your Breast Disease Center of Peking University First Hospital achieved this year? First of all, Prof.
Liu Yinhua is very honored to participate in the "2021 Breast Cancer Annual Progress Review" conference organized by Prof.
Jiang Zefei.
Peking University First Hospital is one of the comprehensive tertiary first-class hospitals in China with a century-old history.
As a teaching hospital , to make accurate diagnosis and standardized treatment of patients, this is the purpose we always adhere to
.
The Breast Disease Center of our hospital was established in 2007.
For more than 10 years, all colleagues in the Breast Disease Center have always adhered to the basic principles of multidisciplinary cooperation, priority in diagnosis, and standardized diagnostic methods
.
The clinical diagnosis and treatment of breast cancer is at the leading level in China, with more than 500 new breast cancer patients treated last year
.
Currently, the Center for Breast Diseases has undertaken two multicenter studies from the Breast Surgery Group of the Chinese Medical Association, among which the CSBrS-015 study evaluated HER-2 positive early breast cancer receiving trastuzumab combined with chemotherapy and trastuzumab + Pathological complete response (pCR) rate and tolerability of neoadjuvant therapy with Pertuzumab combined with chemotherapy regimen.
The total number of patients enrolled exceeds 10,000.
The pCR rate of patients treated with neoadjuvant therapy with dual-target combined chemotherapy regimen nearly 60%
.
However, this study also exposed some problems in the field of breast cancer neoadjuvant therapy.
For example, the ratio of neoadjuvant therapy, especially dual-target therapy, to patients with HER-2-positive early breast cancer in each center is too large, with a specific value of 2%.
-60%, with an average of only about 30% of all patients treated
.
Another study, CSBrS-021, included about 7000 patients with early breast cancer with low HER-2 expression in nearly 30 hospitals across the country, and summarized the clinical rational application data of novel antibody-drug conjugates (ADCs)
.
The exploration of new ADCs is an important part of the classification and treatment of breast cancer.
The Breast Surgery Group of the Chinese Medical Association Surgery Branch hopes to better implement the concept of classification and treatment, and is also writing guidelines related to this concept.
Further promote the development of classification and treatment of early breast cancer
.
What achievements have been made by Yimaitong in the field of breast surgery in 2021, can you make a summary? In 2021, Professor Liu Yinhua, under the guidance of Academician Zhao Yupei, President of the Chinese Medical Association, and 41 colleagues from the Breast Surgery Group of the Surgery Branch of the Chinese Medical Association co-authored China's first clinical practice guideline for breast surgery, "Clinical Practice of Breast Surgery of the Chinese Medical Association.
Guidelines (2021 Edition)", which uses the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system standard as the basis for writing, and divides the evidence levels adopted by the guidelines into four categories: I, II, III, and IV
.
The guideline writing was officially launched in May 2020, completed in May 2021, and has been published in the journal
.
Previously, although many domestic and foreign guidelines provided important references for the diagnosis and treatment of breast cancer, breast surgery still lacked clinical practice guidelines with high-level evidence and suitable for Chinese clinical practice requirements
.
For example, the need for sentinel lymph node biopsy is well understood in clinical practice, but there are no guidelines detailing the choice of tracer, incision location, and pathological evaluation
.
The "Chinese Medical Association Breast Surgery Clinical Practice Guidelines (2021 Edition)" published this time addresses the above issues, the reasonable selection of polygenic testing, and the selection of breast-conserving surgery or preventive bilateral mastectomy for patients with BRCA gene mutations.
A number of questions have given high-level evidence recommendations from a surgical point of view
.
In addition, we are delighted to learn that the People's Health Publishing House has approved the publication of the "Chinese Medical Association Breast Surgery Clinical Practice Guidelines (2022 Edition)" in May 2022
.
In addition to editing and updating the old 6 chapters, the 2022 edition also adds surgical issues in neoadjuvant treatment of breast cancer, upper limb lymphedema after breast cancer surgery, surgical treatment of inflammatory breast cancer, and the first diagnosis of stage IV breast cancer.
4 new chapters of Surgical Treatment Issues
.
Here again, I would like to express my heartfelt thanks to the experts who wrote and participated in the compilation, and sincerely hope to receive criticism and correction from my colleagues
.
Neoadjuvant therapy with Yimaitong has become an important part of breast cancer treatment and is still in the stage of continuous development
.
How do you see the development of neoadjuvant therapy strategies in breast surgery in the future? Under the leadership of Professor Jiang Zefei, Professor Liu Yinhua has made the concept of classification and treatment of breast cancer in China more and more clear.
Standardized diagnosis is the premise of classified treatment and individualized treatment
.
Both CSCO guidelines and NCCN guidelines have made very clear recommendations for the indications of neoadjuvant therapy for early breast cancer, but there are still many practical problems in the current implementation
.
For example, dual-target neoadjuvant therapy for HER-2-positive early breast cancer is still blank in many centers, and the overall proportion of neoadjuvant therapy for HER-2-positive early breast cancer is only 2%-3%, which is undoubtedly different from the current classification therapy.
Times out of touch
.
Compared with the adjuvant therapy and systemic therapy that rely more on physicians, neoadjuvant therapy is closer to the surgeon's own work, and the operation is specialized.
The exploration of neoadjuvant therapy should be implemented into the practice of surgeons
.
I personally think that breast surgeons are one of the most enthusiastic groups of knowledge.
During the study, we surgeons should ask physicians humbly for advice on how to make patients accept and insist on completing neoadjuvant therapy, and how to scientifically conduct neoadjuvant therapy.
Rigorous evaluation of efficacy, how to choose the appropriate timing of surgery and surgical procedures and other key issues
.
It is hoped that under the leadership of CSCO BC, breast oncologists and breast surgeons will be more united, make progress together, and jointly promote the diagnosis and treatment of breast cancer in China to a higher level!
.
This conference focuses on the important progress in the field of international and domestic breast cancer in 2021, and invites well-known experts and scholars in the field of breast cancer to give keynote speeches on the progress of translational research, surgical treatment, radiotherapy, early breast cancer and advanced breast cancer treatment.
A review summarizing important findings that have changed clinical practice in breast cancer
.
During the meeting, Yimaitong had the honor to interview Professor Liu Yinhua of Peking University First Hospital to share with us the research progress of breast surgery and neoadjuvant therapy
.
Professor Liu Yinhua Chief Physician, Professor, Doctor of Medicine, Doctoral Supervisor Chief Physician of Peking University First Hospital Chief Physician of the Chinese Medical Association Surgery Branch Head of the Breast Surgery Group of the Chinese Medical Association Surgery Branch Vice Chairman of the Beijing Medical Association Surgery Branch Beijing Medical Association In 2021, Yimaitong, deputy director of the Breast Disease Branch, will produce frequent research results in the field of breast cancer, which will drive changes in clinical practice.
What breakthroughs has your Breast Disease Center of Peking University First Hospital achieved this year? First of all, Prof.
Liu Yinhua is very honored to participate in the "2021 Breast Cancer Annual Progress Review" conference organized by Prof.
Jiang Zefei.
Peking University First Hospital is one of the comprehensive tertiary first-class hospitals in China with a century-old history.
As a teaching hospital , to make accurate diagnosis and standardized treatment of patients, this is the purpose we always adhere to
.
The Breast Disease Center of our hospital was established in 2007.
For more than 10 years, all colleagues in the Breast Disease Center have always adhered to the basic principles of multidisciplinary cooperation, priority in diagnosis, and standardized diagnostic methods
.
The clinical diagnosis and treatment of breast cancer is at the leading level in China, with more than 500 new breast cancer patients treated last year
.
Currently, the Center for Breast Diseases has undertaken two multicenter studies from the Breast Surgery Group of the Chinese Medical Association, among which the CSBrS-015 study evaluated HER-2 positive early breast cancer receiving trastuzumab combined with chemotherapy and trastuzumab + Pathological complete response (pCR) rate and tolerability of neoadjuvant therapy with Pertuzumab combined with chemotherapy regimen.
The total number of patients enrolled exceeds 10,000.
The pCR rate of patients treated with neoadjuvant therapy with dual-target combined chemotherapy regimen nearly 60%
.
However, this study also exposed some problems in the field of breast cancer neoadjuvant therapy.
For example, the ratio of neoadjuvant therapy, especially dual-target therapy, to patients with HER-2-positive early breast cancer in each center is too large, with a specific value of 2%.
-60%, with an average of only about 30% of all patients treated
.
Another study, CSBrS-021, included about 7000 patients with early breast cancer with low HER-2 expression in nearly 30 hospitals across the country, and summarized the clinical rational application data of novel antibody-drug conjugates (ADCs)
.
The exploration of new ADCs is an important part of the classification and treatment of breast cancer.
The Breast Surgery Group of the Chinese Medical Association Surgery Branch hopes to better implement the concept of classification and treatment, and is also writing guidelines related to this concept.
Further promote the development of classification and treatment of early breast cancer
.
What achievements have been made by Yimaitong in the field of breast surgery in 2021, can you make a summary? In 2021, Professor Liu Yinhua, under the guidance of Academician Zhao Yupei, President of the Chinese Medical Association, and 41 colleagues from the Breast Surgery Group of the Surgery Branch of the Chinese Medical Association co-authored China's first clinical practice guideline for breast surgery, "Clinical Practice of Breast Surgery of the Chinese Medical Association.
Guidelines (2021 Edition)", which uses the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system standard as the basis for writing, and divides the evidence levels adopted by the guidelines into four categories: I, II, III, and IV
.
The guideline writing was officially launched in May 2020, completed in May 2021, and has been published in the journal
.
Previously, although many domestic and foreign guidelines provided important references for the diagnosis and treatment of breast cancer, breast surgery still lacked clinical practice guidelines with high-level evidence and suitable for Chinese clinical practice requirements
.
For example, the need for sentinel lymph node biopsy is well understood in clinical practice, but there are no guidelines detailing the choice of tracer, incision location, and pathological evaluation
.
The "Chinese Medical Association Breast Surgery Clinical Practice Guidelines (2021 Edition)" published this time addresses the above issues, the reasonable selection of polygenic testing, and the selection of breast-conserving surgery or preventive bilateral mastectomy for patients with BRCA gene mutations.
A number of questions have given high-level evidence recommendations from a surgical point of view
.
In addition, we are delighted to learn that the People's Health Publishing House has approved the publication of the "Chinese Medical Association Breast Surgery Clinical Practice Guidelines (2022 Edition)" in May 2022
.
In addition to editing and updating the old 6 chapters, the 2022 edition also adds surgical issues in neoadjuvant treatment of breast cancer, upper limb lymphedema after breast cancer surgery, surgical treatment of inflammatory breast cancer, and the first diagnosis of stage IV breast cancer.
4 new chapters of Surgical Treatment Issues
.
Here again, I would like to express my heartfelt thanks to the experts who wrote and participated in the compilation, and sincerely hope to receive criticism and correction from my colleagues
.
Neoadjuvant therapy with Yimaitong has become an important part of breast cancer treatment and is still in the stage of continuous development
.
How do you see the development of neoadjuvant therapy strategies in breast surgery in the future? Under the leadership of Professor Jiang Zefei, Professor Liu Yinhua has made the concept of classification and treatment of breast cancer in China more and more clear.
Standardized diagnosis is the premise of classified treatment and individualized treatment
.
Both CSCO guidelines and NCCN guidelines have made very clear recommendations for the indications of neoadjuvant therapy for early breast cancer, but there are still many practical problems in the current implementation
.
For example, dual-target neoadjuvant therapy for HER-2-positive early breast cancer is still blank in many centers, and the overall proportion of neoadjuvant therapy for HER-2-positive early breast cancer is only 2%-3%, which is undoubtedly different from the current classification therapy.
Times out of touch
.
Compared with the adjuvant therapy and systemic therapy that rely more on physicians, neoadjuvant therapy is closer to the surgeon's own work, and the operation is specialized.
The exploration of neoadjuvant therapy should be implemented into the practice of surgeons
.
I personally think that breast surgeons are one of the most enthusiastic groups of knowledge.
During the study, we surgeons should ask physicians humbly for advice on how to make patients accept and insist on completing neoadjuvant therapy, and how to scientifically conduct neoadjuvant therapy.
Rigorous evaluation of efficacy, how to choose the appropriate timing of surgery and surgical procedures and other key issues
.
It is hoped that under the leadership of CSCO BC, breast oncologists and breast surgeons will be more united, make progress together, and jointly promote the diagnosis and treatment of breast cancer in China to a higher level!
