CURRENT PRACTICES AND TRENDS OF BREAST-CONSERVING SURGERY IN CHINA: A NATIONWIDE CROSS-SECTIONAL SURVEY hanzhu23@m.fudan.edu.cn

PW04-07

CURRENT PRACTICES AND TRENDS OF BREAST-CONSERVING SURGERY IN CHINA: A NATIONWIDE CROSS-SECTIONAL SURVEY

5

China

Oral or Poster

Breast-conserving surgery (BCS) has become a standard treatment for early-stage breast cancer yet remains underutilized in China. We aimed to assess the current state and emerging trends of BCS practices in China through a nationwide cross-sectional survey.

A standardized questionnaire was distributed to 215 hospitals performing ≥200 breast cancer surgeries in 2022, with 198 centers providing complete BCS data. We collected and analyzed data on hospital characteristics, BCS practices, margin assessment methods, re-excision rates, and BCS with oncoplastic techniques. Data were analyzed using descriptive and statistical methods.

The overall BCS proportion rose to 26.7% in 2022, with a median institutional BCS rate of 22.0%, an increase from 15.0% in 2017 (P<0.001). The survey also demonstrated a rise in the median BCS rate following neoadjuvant therapy (median 20.0% vs. 5.0%, P<0.001). Margin assessment methods showed increased adoption of perpendicular inked margins (33.8% vs. 25.5%, χ2= 2.33, P=0.127) as well as routine use of margin staining (49.4% vs. 24.5%, χ2=18.25, P<0.001) and cavity shaving (56.1% vs. 31.8%, χ2=16.67, P<0.001). The median re-excision rates was 6.0%, with neoadjuvant therapy associated with an increased risk of re-excision (OR=1.029, P=0.002). Oncoplastic techniques showed no significant change in adoption (median 30.0% vs. 30.5%, P=0.164), with their uneven distribution across the country associated with regional disparities in breast and oncoplastic surgical resources.

BCS adoption has improved in China, but variability in practice persists. Standardizing margin assessment and enhancing oncoplastic resources may improve outcomes and access to BCS.