General Surgery Thyroid and Breast Surgery Center

| Basic Overview |--------------

The current academic leader of the Thyroid and Breast Surgery Center of the Department of General Surgery at Huashan Hospital affiliated with Fudan University is Professor Zou Qiang, and Deputy Director Jin Yiting oversees its work. The Thyroid and Breast Surgery Center has 3 chief physicians and 5 associate chief physicians, with a basically reasonable talent structure. It has 120 open beds, offers thyroid and breast specialty outpatient clinics and expert clinics to the public, and is additionally equipped with a day-treatment department, a breast ductoscopy room, and other facilities, giving it a certain scale. It routinely provides standardized, individualized diagnosis and treatment for thyroid and breast diseases, with more than 102500 outpatient visits and nearly 7000 operations annually. The department was named an Advanced Collective of Huashan Hospital in 2023. It is a deputy-chair institution for breast cancer and thyroid cancer in Shanghai and has considerable influence and recognition in its professional field and nationwide.

| Historical Development |--------------

The specialization of thyroid and breast surgery at Huashan Hospital affiliated with Fudan University can be traced to the specialized grouping of Huashan General Surgery in 1985, making it one of the first subspecialty groups established in general surgery. Its inaugural academic leaders were Professor Zhu Xiqi and Associate Professor Zhuang Qingping; Professor Zhang Yanling and Professor Wang Dezhao also participated in providing guidance. In 2001, the former Shanghai Real Estate Bureau Employees Hospital (abbreviated as “Shangfang”) merged into Huashan Hospital, and the thyroid and breast surgery group as a whole relocated to the former “Shangfang” site (now the Jiangsu Road Branch), where Huashan Oriental Breast Specialty Hospital was established. The Thyroid and Breast Surgery Center of the Department of General Surgery was established in July 2023.

| Clinical Work |--------------

Under a development philosophy that advances early diagnosis and standardization, individualized treatment, and both “major invasive” procedures (mastectomy and reconstruction) and “minimally invasive” procedures (breast-conserving surgery, endoscopic thyroid surgery, and minimally invasive local treatment of the breast), the Thyroid and Breast Surgery Center makes full use of Fudan University’s strong resources and Huashan Hospital’s advantageous platform. It carries forward the excellent tradition of multidisciplinary collaboration and joint research, bringing together multidisciplinary teams from radiology, pathology, plastic surgery, nephrology, endocrinology, and other specialties to establish a new surgical-led comprehensive treatment model for diseases of the thyroid and breast systems. On average, more than 2000 patients with breast cancer and more than 1200 patients with thyroid cancer from throughout China are admitted annually.

Thyroid and Parathyroid:

The center performs endoscopic thyroid surgery through multiple approaches; lateral cervical region/mediastinal lymph node dissection; treatment of difficult and critically ill thyroid diseases; nerve monitoring and parathyroid preservation during thyroid surgery; diagnosis and treatment of multiple endocrine neoplasia; and familial studies of medullary thyroid carcinoma. Making full use of Huashan’s advantageous imaging-diagnosis platform, it performs ultrasound-guided aspiration cytology, bringing the level of early diagnosis of thyroid tumors into line with international standards. It has 25 years of single-center experience in the surgical treatment of renal hyperparathyroidism, and its surgical treatment of renal secondary hyperparathyroidism (total parathyroidectomy and autotransplantation) is at the forefront in China.

Breast:

Benefiting from the specialized model and integrated diagnosis and treatment encompassing preoperative examinations, biopsy diagnosis, surgical treatment, and comprehensive day treatment, the five-year survival rate of patients with breast cancer exceeds 90%. Through comprehensive treatment approaches, including neoadjuvant treatment, oncoplastic breast-conserving surgery, and total breast reconstruction (implant-based and autologous, including free flaps), the proportion of breast-conserving or breast-reconstruction surgeries reaches 60%, placing the center at the forefront nationwide. It enables every patient to receive comprehensive, individualized, precise diagnosis and treatment. Its main specialties include:

A) Early diagnosis of breast cancer: In 1992, the center was the first in China to carry out the detection, stereotactic localization, and biopsy of nonpalpable breast lesions. In 1997, it became one of the leading institutions in China to pioneer breast MRI, ductoscopy, and other technologies. In 1999, its use of ultrasound-guided Mammotome technology ranked among the leading efforts in China. It has a comprehensive range of equipment, including full-field digital mammography, high-frequency color Doppler ultrasound, magnetic resonance imaging, ductoscopy, sentinel lymph-node detection, and a Mammotome biopsy system. It has detected a large number of early breast tumors, including occult breast cancers that cannot be palpated clinically, particularly precancerous lesions, placing it at the forefront in China.

B) Minimally invasive techniques: Ultrasound-guided Mammotome minimally invasive rotary excision of breast fibroadenomas, breast-conserving and axilla-preserving surgery for breast cancer, and endoscopic mastectomy are applied with flexibility and proficiency.

C) Oncoplastic and reconstructive breast surgery: This enables patients who have undergone mastectomy to reshape their appearance and rebuild their confidence. The center independently performs various types of oncoplastic breast tumor surgery and immediate breast reconstruction for breast cancer, particularly free deep inferior epigastric artery perforator flap transfer for breast reconstruction (DIEP), hailed as the pearl in the crown of reconstruction. It has also innovatively used internal thoracic artery intercostal perforators as recipient vessels and anastomosed them to the inferior epigastric artery, shifting from following others to innovation. This work was recognized as an annual clinical advance at the National Breast Cancer Conference.

D) Breast cancer screening and prevention: The center provides breast examinations and health-care counseling, breast cancer susceptibility gene testing, identification of high-risk individuals, and preventive drug treatment.

E) Locally advanced breast cancer: Comprehensive treatment and full-course management.

F) Benign breast diseases: The center has extensive experience in the diagnosis and treatment of various benign breast diseases, including mammary hyperplasia, mastitis, and nipple discharge, as well as in ductoscopy and related procedures.

| Medical Education and Research |--------------

The Thyroid and Breast Surgery Department of Huashan Hospital integrates medical care, education, and research and is one of the doctoral degree authorization sites in surgery. It currently has 1 doctoral supervisor and 2 master’s supervisors. It undertakes the routine teaching of undergraduate and graduate students, residents and specialty-training trainees, and visiting physicians. It attaches importance to basic medical education and actively explores and standardizes the procedures and content of teaching ward rounds. It offers postgraduate medical education courses. Since 1999, it has continuously and successfully organized the National Breast Surgery Training Course and a series of academic salons. Research has been conducted on cellular immunotherapy for breast cancer, mechanisms of and strategies for breast cancer drug resistance, comparative optimization of multidisciplinary diagnosis of breast diseases, and parathyroid autotransplantation. The department has undertaken multiple projects funded by the National Natural Science Foundation of China and by municipal Science and Technology Commission and Health Commission programs. It has led and participated in multiple large-scale clinical trials and published many academic papers in high-impact-factor journals. The popular-science microfilm “Pink Butterfly” exceeded one million views within 3 hours of its release.

| Academic Influence |--------------

The Thyroid and Breast Surgery Department of Huashan Hospital is a deputy-chair institution of the Breast Cancer Specialized Committee and the Youth Committee of the Shanghai Anti-Cancer Association, and an institution serving as deputy group leader of the Breast Surgery Group of the General Surgery Branch of the Shanghai Medical Association.

It has led and participated in the development of multiple national guidelines and consensus statements, including “Clinical Practice Guidelines for Breast-Conserving Surgery for Early Breast Cancer in China”, “Clinical Practice Guidelines for the Diagnosis and Treatment of Invasive Breast Cancer in China”, “Guidelines and Standards for the Diagnosis and Treatment of Breast Cancer of the Chinese Anti-Cancer Association”, and “Guidelines for the Treatment of Breast Carcinoma in Situ of the Chinese Anti-Cancer Association”. It has served as chief editor or contributing editor of multiple monographs, such as “Breast Surgery”, “Modern Surgery”, “Practical Surgery”, “Atlas of Surgical Procedures”, and “Breast Oncology”. It has considerable influence in the profession.

| Expert Team |--------------

Academic leader: Professor Zou Qiang, chief physician and doctoral supervisor. Academic leader of the Thyroid and Breast Surgery Center of the Department of General Surgery at Huashan Hospital affiliated with Fudan University, and director of the special-needs ward. Deputy director of the Fudan University Breast Cancer Institute. Deputy chair of the Thyroid Cancer Specialized Committee of the Shanghai Anti-Cancer Association. Recipient of the 2019 nomination award for “Shanghai Benevolent Physician,” the 2023 “Medical Craftsman of Shanghai” title, and the 2023 Excellence Award in the audio-video category of health science popularization works.

Deputy director of the department (overseeing the work): Professor Jin Yiting, chief physician and master’s supervisor. She has led 6 projects funded by the National Natural Science Foundation of China and at the provincial/ministerial and bureau levels, and has published more than 20 SCI papers with herself as both the first and corresponding author. Member of the Breast Cancer Specialized Committee of the Chinese Anti-Cancer Association and deputy chair in Shanghai. Deputy group leader of the Breast Surgery Group of the General Surgery Branch of the Shanghai Medical Association. Deputy chair of the Breast Specialized Committee of the Shanghai Female Physicians Association. Young expert of the Breast Oncology Group of the Chinese Medical Association. Deputy chair of the Youth Committee of the Breast Group of the China Maternal and Child Health Association. Member of the Thyroid Cancer Specialized Committee of the Shanghai Anti-Cancer Association. Recipient of the Science Popularization Award of the Shanghai Anti-Cancer Science and Technology Award, the Excellence Award of the Chinese Medical Association Oncology Branch’s “Chinese Oncology, Doctors of Tomorrow,” the Young Talent Award of the General Surgery Branch of the Shanghai Medical Association, the Huashan Hospital Outstanding Medical Care Award, the Backbone Talent (Huajing Award) Incentive Program award, and honors including one of the Top Ten Science and Technology Elites and one of the Top Ten Outstanding Teachers. She is a clinical research scholar at Harvard Medical School and a visiting scholar in breast oncoplastic surgery at the University Hospital of Siena, Italy.

Thyroid and Breast Surgery Department group photo.