Clinical practice guideline for breast-conserving surgery in patients with early-stage breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021

Abstract

Breast-conserving surgery (BCS) with radiotherapy is the primarily agreed surgical choice for eligible patients with an early diagnosis of breast cancer. In 2019, the panel of Chinese experts assembled by the Chinese Society for Breast Surgery (CSBrS) developed a Chinese experts' consensus on BCS for early-stage breast cancer (Version 2019) with the aim of standardizing BCS in China. Subsequently, the CSBrS conducted a review of published reports and discussions between experts to determine the key clinical questions for the Clinical Practice Guideline for BCS in Patients with Early-Stage Breast Cancer. The group evaluated the relevant evidence using the grading of recommendations assessment, development, and evaluation system, and developed a Clinical Practice Guideline for BCS in Patients with Early-Stage Breast Cancer (Version 2021), with the aim of providing guidance on clinical practice to breast surgeons in China. Level of Evidence and Recommendation StrengthLevel of evidence standard [1] Recommendation strength standard [1] Recommendation strength review committeeThe panel for this guideline is comprised of 85 experts, including 70 (82.3%) breast surgeons, four (4.7%) medical oncologists, four (4.7%) diagnostic radiologists, two (2.4%) pathologists, one (1.2%) obstetrician, two (2.4%) radiation oncologists, and two (2.4%) epidemiologists.

Chinese Society of Breast Surgery (CSBrS) Practice Guideline 2022

“…❖ Definition: BCS is one of the treatment methods for the radical operation of breast cancer (level of evidence: I; recommendation strength: A) ( 53 ).…”

“…❖ Indication (all of the indications should be met): patient wishes to preserve her breast; clinical stage I, II, or ≤ cT2; able to achieve acceptable cosmetic outcomes after BCS (level of evidence: I; recommendation strength: A) ( 53 ).…”

“…❖ Contraindication (any one of the indications is sufficient): cannot receive RT after BCS; unable to achieve negative surgical margins; extensive microcalcification; inflammatory breast cancer; patient refusal to undergo BCS (level of evidence: I; recommendation strength: A) ( 53 ).…”

“…It is recommended that inert metal clips (e.g., titanium clips) be placed in the surgical bed after BCS as a localization marker for radiation boosting (level of evidence: I; recommendation strength: A) ( 53 ).…”

Correlations between dynamic-enhanced magnetic resonance imaging quantitative parameters and postoperative recurrence or metastasis and clinicopathological features in breast cancer patients—a retrospective cohort study

“…For breast cancer patients diagnosed for the first time, the current international breast cancer treatment guidelines recommend a dynamic-enhanced magnetic resonance imaging (MRI) examination to determine whether there is lymph node metastasis, evaluate tumor staging (T staging), clarify the scope of tumor invasion, etc., to help clinicians develop individualized treatment plans. MRI has an irreplaceable role in diagnosing and guiding the chemotherapy of invasive breast cancer (2)(3)(4).…”