Breast Surgery

Peking University People's Hospital Breast Center was established in 1992. It was the first breast center in China to be named and characterized by an integrated model combining medical care, research, teaching, and screening. The center is dedicated to early diagnosis and treatment and comprehensive treatment of breast cancer, providing patients with integrated care ranging from outpatient imaging diagnosis and inpatient surgery to postoperative chemotherapy and other systemic treatments. Today, the center has achieved remarkable results in all areas of its work.

The center currently has 6 chief physicians, 5 associate chief physicians, 3 attending physicians, and 4 resident physicians; 3 supervising nurses, 9 nurses, and 8 nursing assistants. It was founded by Professor Zhang Jiaqing, a leading figure in surgery. Professor Qiao Xinmin and Professor Yang Deqi subsequently served as directors, and Professor Wang Shu has been director since 2014.

Since its establishment, the center has strictly required a high standard of breast tumor imaging diagnosis. All physicians must personally perform breast ultrasonography, mammography, and breast MRI interpretation. 30 years of determined progress have enabled the center to diagnose more than 1000 newly diagnosed breast cancer cases annually, with ductal carcinoma in situ accounting for nearly 20% and stage I and II breast cancer accounting for more than 75%, placing it among the leading centers in China.

In the 1990s, the center was among the first in China to widely perform breast-conserving surgery, with the rate remaining stable at 40%. During the same period, it was also among the first in China to use the “paclitaxel＋epirubicin” regimen for neoadjuvant chemotherapy in patients with locally advanced breast cancer. In 2010, the center was the first in China to conduct fluorescence-guided sentinel lymph-node biopsy for breast cancer. Once reported, this attracted extensive attention in the profession, and hospitals at all levels across China successively sent staff to the center for observation, study, and exchange. In 2016, the center’s project “Standardized Application and Optimization of Surgical Methods and Assessment Strategies for Breast Cancer Axillary Lymph Nodes” received the Beijing Science and Technology Award. At the end of 2017, Director Wang Shu’s Breast Cancer Axillary Lymph-Node Assessment and Management—Wang Shu’s 2017 Views was published by Science and Technology Literature Press. After 10 years of effort to identify safe and effective surgical methods and assessment strategies for breast cancer axillary lymph nodes, the long-term follow-up results were published online in Breast Cancer Research and Treatment in March 2021. This technique allows patients with early breast cancer to avoid axillary lymph-node dissection, avoids the risk of postoperative lymphedema in the affected limb, and effectively improves quality of life.

The center actively invites specialists from 12 departments, including plastic surgery, pathology, bone oncology, radiology, interventional medicine, nuclear medicine, pain medicine, thoracic surgery, radiation oncology, cardiology, laboratory medicine, and reproductive medicine, to participate in multidisciplinary team (MDT) rounds and discuss difficult cases. Particular attention is paid to bone metastasis, visceral metastasis, postoperative breast reconstruction, and postoperative lymphedema of the affected limb. Interdepartmental communication has been strengthened, and the center has jointly formulated diagnostic and treatment protocols for breast-cancer bone metastasis, postoperative breast reconstruction, and prevention and treatment of postoperative lymphedema, as well as a genetic testing workflow for breast cancer. It has established comprehensive teams for breast-cancer bone metastasis, breast-cancer lymphedema, and breast-cancer genetic diagnosis, and created specialist clinics, bringing relief to patients suffering from breast-cancer complications.

In 2016, all physicians at the center jointly translated the authoritative breast-imaging diagnostic work BI-RADS Classification (5th Edition). This classic work of several hundred thousand Chinese characters has become a recognized gold standard in breast imaging diagnosis.

In 2017, initiated by the center and jointly undertaken with young breast physicians from other hospitals, Breast Cancer: Interpretation of Classic Literature was written under the principles of “interpreting classics, keeping up with trends, getting to the bottom of things, and leaving no detail unexplained,” resonating with physicians of all generations in the profession.

Since its establishment, the center has actively conducted and participated in numerous major clinical studies in China and abroad, including the national “Tenth Five-Year Plan” key project “Study of Standardized Breast-Conserving Treatment for Early Breast Cancer”; the National Natural Science Foundation project “Application of Inhibition of Homologous Recombination Repair in Preventing Familial Hereditary Breast Cancer”; and Capital Medical Development Fund projects including “Clinical Trial of Autologous Fluorescent Substances for Sentinel Lymph-Node Biopsy in Breast Cancer,” “Clinical Trial Comparing TA and TX Regimens for Neoadjuvant Chemotherapy in Breast Cancer,” “Study of Ovarian-Reserve Protection by GnRHa During Breast-Cancer Chemotherapy in Women of Reproductive Age,” “Multicenter Study of Intelligent Diagnosis Based on the DCI Mode of Optical Coherence Imaging for Intraoperative Assessment of Breast-Cancer Sentinel Lymph Nodes,” “Study of Nucleic-Acid Mass-Spectrometry Detection of Drug-Metabolizing-Enzyme Gene Polymorphisms to Predict Neurotoxicity After Breast-Cancer Chemotherapy,” “Study of Organelle Interactions and LncRNA Transport During Malignant Transformation of Normal Cells Based on Super-Resolution Imaging,” and “Human-Derived Tumor-Like Tissue Cell Clusters for Cancer Drug-Sensitivity Testing.” These results have been published in leading or well-known international journals, including Science Translational Medicine, Cancer, Human Reproduction, and Breast Cancer Research and Treatment. They have also been accepted in various forms at international breast-cancer conferences, including successive ASCO and ESMO meetings, the San Antonio Breast Cancer Symposium, and the St Gallen conference. In 2020, the center participated in the project “Integrated Research and Clinical Application of Molecular-Imaging-Guided Breast-Cancer Diagnosis and Treatment,” which won the second prize of the China Anti-Cancer Association Science and Technology Award.

The center’s physicians now hold academic positions across all major academic organizations in the breast-medicine field, including the Chinese Society of Clinical Oncology, the Surgical Physicians Branch of the Chinese Medical Doctor Association, the Breast Cancer Professional Committee of the China Anti-Cancer Association, and the Oncology Branch of the Chinese Medical Association. They have also repeatedly served as speakers, panelists, or moderators at major academic conferences in the United States, Japan, Australia, and other countries. Several physicians have participated in preparing important national guidelines, including the Chinese Society of Clinical Oncology Guidelines for Breast Cancer Diagnosis and Treatment, advancing standardized breast-cancer care nationwide. The center also shares the concepts and techniques of standardized breast-cancer diagnosis and treatment with primary hospitals and leads standardized breast-cancer care throughout China. Each year it hosts the breast-surgery session of the Chinese Medical Doctor Association Annual Congress, providing a platform for professional exchange and academic sharing. Every quarter it holds an “Intensive Training Camp for Breast Imaging Diagnosis and Minimally Invasive Biopsy,” training more than 100 primary-hospital physicians and receiving wide acclaim. Since April 2020, it has held the Peking University People's Hospital Visiting Physician Alliance online seminar every month, interpreting classics and keeping up with trends for breast specialists from dozens of hospitals nationwide.

In addition to focusing on its own rapid development, the center has always adhered to a people-oriented, patient-centered philosophy of diagnosis and treatment. In particular, in December 2010 it established the “Yangguan Caring Volunteers” Club. Each quarter, it conducts 1 patient health-education lecture; each month, club volunteers visit new breast-cancer patients in the wards, communicate with them emotionally, and answer their questions. A volunteer induction ceremony is held every half-year, together with varied cultural and recreational activities such as a karaoke competition and fashion show for patients and friends. These efforts have received praise and support from breast-cancer patients.

These achievements fully demonstrate that the Peking University People's Hospital Breast Center’s strength in early diagnosis and treatment of breast cancer is internationally aligned and at an advanced domestic level. After selection, the center was designated by the Ministry of Health as a National Clinical Key Specialty—General Surgery (Breast) and Oncology (Breast); a practical training base for the Ministry of Health National Rational Drug Use Training Program for Primary Medical Institutions; one of the first Ministry of Health “Pain-Free Standardized Wards”; and a national training base for the Wu Jieping Medical Foundation Standardized Early Diagnosis and Treatment Training Program. It was also designated as one of Beijing’s first teaching bases for oncology specialist nurses and one of Beijing’s first clinical teaching bases for specialist nurses in intravenous infusion therapy.