[Breast reconstruction after mastectomy in breast cancer patients: specialization and standardization].

In recent years, with the improvement of screening and early diagnosis, the overall prognosis of breast cancer patients has been greatly improved in China. Breast reconstruction is an option to improve cosmetic outcomes and quality of life for the patients received mastectomy, this procedure has attracted a lot of attention. The breast reconstruction surgery is recommended by the 2018 NCCN Clinical Practice Guidelines in Oncology for Breast Cancer in patients with appropriate indications. Despite the high proportion of breast reconstruction after mastectomy in western countries, Chinese breast surgeon should objectively understand the differences in breast structure and cultural backgrounds between Chinese and foreign women, and conduct rigorous clinical practice on the basis of calm thinking. In particular, it should be clearly recognized that we have more local advanced and high-risk cases in newly diagnosed breast cancer patients. Making efforts to improve the overall survival for patients with breast cancer must be the top priority for our surgeon. Breast reconstruction for all patients without identifying the distinction of personal characters and indications should be avoided, and the pursuing of high proportion of clinical data with no consideration of the realities of clinical practice in China should also be avoided. The indication of breast reconstruction for breast cancer patients received mastectomy must be strictly determined by the surgeon.近年来，随着国内乳腺癌筛查和早期诊断水平的提高，乳腺癌患者总体预后得到极大改善。同时，针对接受乳房切除手术的患者实施不同方式的乳房重建以提高生活质量的理念受到关注。2018年NCCN乳腺癌临床实践指南也继续推荐乳房重建手术是适应证患者的标准术式。中国乳腺外科临床医师在了解国际医学发展动态的同时，更应该客观认识中国女性的乳房结构特点与社会文化背景差异，在冷静思考的基础上开展严谨的临床实践。尤其应该清醒地认识到，中国乳腺癌局部晚期和肿瘤学高危病例仍占较大比例。临床医师应首先考虑为提高患者总体生存率作出努力，并严格谨慎地选择重建适应证人群，避免不适宜国情的盲目依从和单纯追求乳房高重建比例的中国临床数据。.