CURRENT PRACTICES AND CHALLENGES OF AUTOLOGOUS BREAST RECONSTRUCTION IN CHINA: A QUESTIONNAIRE-BASED AND NATIONWIDE CROSS-SECTIONAL SURVEY OF 198 HOSPITALS luxy18@fudan.edu.cn

PW04-20

CURRENT PRACTICES AND CHALLENGES OF AUTOLOGOUS BREAST RECONSTRUCTION IN CHINA: A QUESTIONNAIRE-BASED AND NATIONWIDE CROSS-SECTIONAL SURVEY OF 198 HOSPITALS

3

China

Oral or Poster

Autologous breast reconstruction (ABR) provides aesthetic and functional advantages, particularly for patients receiving radiotherapy. However, the utilization of ABR in China remains limited. The aim of this study was to evaluate the current status, temporal trends, and institutional disparities in ABRs nationwide.

A national cross-sectional survey was conducted in 2022 across 198 hospitals performing breast cancer surgery. Data on institutional profiles, surgical volume, reconstruction techniques, complications, and influencing factors were collected and analysed.

Among the 198 hospitals, 169 (85.4%) performed breast reconstruction, and 110 (65.1%) performed ABR. The most common techniques were latissimus dorsi flaps (28.9%), LDF with implants (28.0%), pedicled TRAM (15.7%), and DIEP flaps (12.9%). Compared with 2017, the use of LDF with implants and pedicled TRAMs declined, whereas the use of DIEP and other perforator flaps increased. ABR was more frequently offered by institutions located in economically developed regions and those equipped with plastic surgery departments. Most centres prefer delayed reconstruction in patients receiving radiotherapy. Although implant-based reconstruction remains predominant, ABR, particularly DIEP, is gaining traction, albeit with uneven access and expertise across institutions.

ABR is gradually increasing in China, with a shift towards perforator flap techniques such as DIEP; however, its provision remains concentrated in tertiary centres with robust surgical infrastructure and multidisciplinary support. Regional disparities and limited microsurgical expertise constrain broader adoption. Targeted training and standardized protocols are essential to improve access and optimize reconstructive quality nationwide.