Objective: To investigate the current trends of breast reconstruction(BR) after mastectomy in China. Methods: A list of hospitals with more than 200 cases of breast cancer surgery per year nationwide was obtained, and 110 institutions were selected according to the geographical distribution. The research was conducted in the form of a questionnaire survey, and 92.3% (169/183) of the questions were single-choice questions. Information such as demographics of surgeons and hospitals, number of mastectomy and BR, type and timing of BR was included in the survey. Survey formal notification letter was issued by the China Anti-Cancer Association Breast Cancer Committee and Chinese College of Surgeons, Committee of Mammary Surgeons. Questionnaires were sent to the respondents of each center by email. The survey time range was from January 1, 2017 to December 31, 2017. All data were completely collected before September 7, 2018. Results: A total of 110 units participated in the survey. In total, 87.3% (96/110) of the hospitals have conducted BR surgery. The BR after mastectomy was 10.7% (6 534/61 099), among this, implant BR accounted for 65.7%(4 296/6 534), autologous BR accounted for 20.1% (1 312/6 534), and autologous combined implant BR accounted for 14.2% (927/6 534). Immediate reconstruction accounted for 67.6% (4 417/6 534) of BR, while delayed BR accounted for 32.4% (2 097/6 534). In 2017, 77.8% (35/45) of the plastic surgery departments cooperated with general surgery departments. General BR could be conducted after mastectomy accounted for 83.6% (92/110). The proportion of reconstruction was positively correlated with the gross domestic product (GDP) per capita (r=0.311, P=0.002). The one-step implant-based BR(IBBR) was the most preferred type in immediate BR. Two-step IBBR was the most preferred method in delayed BR. Hospitals that routinely evaluated aesthetics after BR accounted for 64.6% (62/96), while only 16.7% (16/96) of hospitals used patient-reported outcome measure (PROM). The most commonly used PROM tool was BREAST-Q. Conclusions: The overall BR in China is on upward trend, but gap between China and the developed countries still exists. Breast surgery departments should strengthen further cooperation with plastic surgery departments. Simultaneously, the aesthetics evaluation and PROM after BR should be put a high premium.
目的： 探讨中国全乳切除术后乳房重建手术的开展情况现状。 方法： 获取全国乳腺癌年手术量>200例的医院列表，根据地理分布选取110家机构作为调查对象。以问卷调查形式开展研究，92.3%(169/183)的问题为单项选择题。问卷调查内容包括手术医师及其所在科室和医院的基本情况、2017年乳腺癌手术开展情况、各类型重建手术开展情况及其相关因素。由中国抗癌协会乳腺癌专委会、中国医师协会外科医师分会乳腺外科医师专委会办公室发布调研项目通知函，通过邮件发送至各家医院受访者。调查时间范围为2017年1月1日至2017年12月31日。所有数据在2018年9月7日前完成填报。 结果： 共110家医院参与调研，其中87.3%(96/110)的医院已开展重建手术。全乳切除术后总重建比例为10.7%(6 534/61 099)。植入物重建占总重建手术量的65.7%(4 296/6 534)，自体重建占20.1%(1 312/6 534)，自体联合假体重建占14.2%(927/6 534)，即刻重建占67.6%(4 417/6 534)，延期重建占32.4%(2 097/6 534)。77.8%(35/45)的医院整形外科与普外科常规开展合作。常规告知患者行乳房切除后可行重建术占83.6%(92/110)。重建比例与所在地人均国内生产总值呈正相关(r＝0.311, P＝0.002)。即刻重建首选最多的为假体一步法，延期重建首选最多的为扩张器－假体两步法。常规测评美观度的医院占64.6%(62/96)，仅16.7%(16/96)的医院使用患者报告结局测量工具(PROM)。最常用的PROM工具为BREAST－Q。 结论： 中国乳房重建整体呈向上发展趋势，但较发达国家仍有差距。乳腺外科应进一步加强与整形外科合作。重建的美观度和满意度评价应当受到重视。.
Keywords: Breast neoplasms; Breast reconstruction; Questionnaire survey.