1.Can breast cancer patients preserve their breasts? A: Most of the patients with early stage I and II breast cancer, the largest diameter of the tumor generally does not exceed 3 cm and can maintain good breast shape after surgery can undergo breast-conserving surgery. Breast-conserving surgery includes wide local excision of the tumor plus axillary lymph node dissection or sentinel lymph node biopsy. Postoperative whole breast radiotherapy is also required to reduce the local recurrence rate. This is complemented by postoperative systemic therapy as necessary, such as chemotherapy and/or endocrine therapy. Some patients with large tumor size and small breasts will have poorer cosmetic results after breast-conserving surgery. Some other patients can also undergo breast-conserving surgery after the lump shrinks after chemotherapy before surgery, but still need to choose carefully. 2.What are the types of surgery for breast cancer? A: Breast-conserving surgery, total mastectomy, modified radical surgery, radical surgery and expanded radical surgery are the most commonly used surgeries for breast cancer. Currently, the first three types of surgery are widely used in China. Breast-conserving surgery is suitable for patients with clinical stage I and II early-stage breast cancer and have the desire to preserve breast; total mastectomy can be performed without radiotherapy for non-invasive or early-stage cases without axillary lymph node metastasis; for locally more advanced breast cancer with simple excision can be supplemented with radiotherapy. Modified radical surgery is basically the same as radical surgery, in which the whole breast and axillary lymphatic tissues are removed in one piece. With the development of various adjuvant therapies, radical surgery and extended radical surgery are basically rarely used now. 3.What patients are not suitable for breast-conserving surgery? A: The following types of patients are not suitable for breast-conserving surgery. (1) Patients who have previously received radiotherapy to the same breast and chest wall; (2) Patients whose cancer is multiple and it is difficult to achieve negative surgical margins or preserve the ideal shape; (3) Patients whose tumors have positive margins after extensive local excision and still cannot guarantee negative pathological margins after re-excision; (4) Patients with special inflammatory breast cancer. 4.Why do certain surgical patients need chemotherapy before surgery? A: Drug therapy is given before surgery and surgery is performed after the treatment is effective, so the preoperative drug therapy is generally called neoadjuvant therapy, including neoadjuvant chemotherapy and neoadjuvant endocrine therapy. Neoadjuvant therapy can verify the efficacy of drugs and improve the survival rate of patients who have achieved complete remission after neoadjuvant therapy. However, we remind patients that neoadjuvant therapy has its own strict indications and standard treatment protocols, including drug selection, dose and treatment schedule. The internationally recommended course of neoadjuvant chemotherapy is generally 4 to 6 cycles, and the duration generally takes 3 to 4 months. 5.How long do I need to review after surgery? Regular review is recommended once every 3 to 6 months for 2 years after surgery, once every 6 months for 2 to 5 years, and once a year after 5 years. 6.What is breast reconstruction? A: Breast reconstruction refers to the reconstruction of a breast after mastectomy. According to the time of breast reconstruction, it can be divided into immediate (phase I) reconstruction and delayed (phase II) reconstruction. Immediate reconstruction means breast reconstruction is performed during the surgery of breast cancer removal, and the treatment of tumor surgery and breast reconstruction surgery are completed at one time. Second-stage breast reconstruction refers to breast reconstruction surgery 1 to 2 years after breast cancer surgery, if there is no sign of recurrence after review. 7.Are all patients suitable for breast reconstruction? A: Breast reconstruction is suitable for women who are ready to undergo or have undergone mastectomy for various reasons, or for patients with significant breast deformation due to breast-conserving surgery. As long as there is no systemic metastasis of breast cancer, patients who are interested in breast reconstruction can consult with their doctors to learn about breast reconstruction. 8.When is breast reconstruction appropriate after surgery? A: Breast reconstruction can be done as soon as the breast is removed or after all radiotherapy is completed. Immediate reconstruction means that breast reconstruction is performed at the same time as the breast cancer surgery, and the radical tumor surgery and breast reconstruction surgery are completed at the same time. Second-stage breast reconstruction refers to breast reconstruction surgery after breast cancer surgery, if there is no sign of recurrence after review. The advantage of immediate breast reconstruction is that only one surgery is needed, there is no experience of breast loss after surgery, and less mental and psychological pain is suffered. The advantage of second-stage reconstruction is that the patient has the personal experience of breast loss, can make rational judgment on breast reconstruction, and has high satisfaction after surgery; the disadvantage is that two surgeries are needed and the cost of surgery is high. 9.How to choose breast reconstruction for patients who need radiotherapy after surgery? A: For patients who clearly need radiotherapy after surgery, it is recommended that tissue expanders be placed first and replaced with permanent prosthesis after radiotherapy is completed. For patients who require reconstruction with an autologous flap, it is also recommended to delay until after chemotherapy or radiotherapy is completed. This is because radiation therapy may have a negative impact on the shape of the reconstructed breast. Experienced teams may consider immediate reconstruction with tissue expansion and implants followed by conformal radiotherapy. If the patient has already received radiotherapy, the use of tissue expanders and implant reconstruction is not recommended, as these patients often experience more severe postoperative complications such as capsular contracture, displacement, poor breast aesthetics, and easy exposure of implants. 10.How should patients choose the right implant for them? A: Implants can generally be divided into silicone implants and saline implants according to the material, silicone implants generally have a soft feel, good realistic effect, and relatively expensive. Saline prosthesis, although cheap, feel general, but easier to produce rupture. If rupture occurs, the saline in the prosthesis can be absorbed naturally and no residue will be produced. According to the shape of the implant, it can be divided into drip-shaped and hemispherical. Generally, breast cancer patients are older and have sagging breasts, so the drip shape is used more often. The volume of the implant is usually determined by the size of the contralateral breast. If necessary, the shape of the contralateral breast can be adjusted to achieve consistency.