2026年6月23日—28日，北京乳腺癌论坛暨北京乳房重建论坛在京盛大召开。本次会议汇聚国内外乳腺外科领域顶尖专家，围绕乳腺癌诊疗、乳房重建及肿瘤整形保乳手术等前沿议题展开深入交流。在“国际视野·学术高峰”篇章中，来自美国Hoag乳腺中心的Sadia Khan教授作了题为 Bridging the Learning Curve: Building a Comprehensive Training Curriculum for Oncoplastic Breast Surgeons 的报告，系统介绍了美国在肿瘤整形保乳外科医生培训体系建设方面的经验与探索，并在接受《肿瘤瞭望》的采访中进一步分享其对中美乳腺癌整形保乳手术发展和培训的看法。
编者按：2026年6月23日—28日，北京乳腺癌论坛暨北京乳房重建论坛在京盛大召开。本次会议汇聚国内外乳腺外科领域顶尖专家，围绕乳腺癌诊疗、乳房重建及肿瘤整形保乳手术等前沿议题展开深入交流。在“国际视野·学术高峰”篇章中，来自美国Hoag乳腺中心的Sadia Khan教授作了题为 Bridging the Learning Curve: Building a Comprehensive Training Curriculum for Oncoplastic Breast Surgeons 的报告，系统介绍了美国在肿瘤整形保乳外科医生培训体系建设方面的经验与探索，并在接受《肿瘤瞭望》的采访中进一步分享其对中美乳腺癌整形保乳手术发展和培训的看法。
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《肿瘤瞭望》：能否请您概述一下肿瘤整形保乳手术在美国的发展历程？尽管美国与中国等亚洲国家在人口结构等方面存在差异，您认为美国模式中有哪些经验和做法值得借鉴？
Sadia Khan教授：肿瘤整形手术实际上最早起源于欧洲，并在那里得到推广。美国在这方面起步稍晚一些。真正推动肿瘤整形手术诞生的起点，是比较乳房全切术与保乳手术的一系列临床试验。当我们意识到女性接受创伤更小的手术也能获得同样好的疗效后，术后美观效果的重要性便开始受到更多关注。
一些欧洲的外科医生影响了美国同行，而美国肿瘤整形手术领域公认的奠基人是梅尔文·西尔弗斯坦（Melvin J. Silverstein）医生。我也曾接受过他的培训。他和许多其他外科医生一起，将肿瘤整形手术作为核心理念在美国推广开来。
在过去的十年里，我亲眼看到了一种巨大的变化趋势——越来越多的外科医生接受培训，以便为普通社区的患者提供肿瘤整形保乳手术，让更多患者受益。这种趋势不仅体现在培训项目中开始纳入肿瘤整形手术的内容，也体现在各类学术会议上——现在有很多相关的讲座和专题讨论。像美国乳腺外科医师协会（ASBrS）等组织，以及其他许多学会，都在举办各类培训班，为那些过去没有接受过肿瘤整形培训的外科医生提供学习机会。
我认为中国也存在类似的情况。在北京、上海等主要医疗中心，他们正在开展肿瘤整形手术，但许多其他地区的医院和外科医生可能还没有太多机会接触。我认为，在中国可以让这方面得到推广的一个做法是：如果并非每个中心都有足够的手术量来开展这项技术，那么外科医生可以前往手术量较大的中心进行学习；或者由国内该领域的领军专家牵头举办培训班，提供学习和积累经验的机会。当然，将肿瘤整形手术纳入正规培训体系，是实现广泛普及的最佳途径。
Oncology Frontier: Could you give us an overview of the history and development of oncoplastic breast surgery in the United States? And despite differences in demographics and other factors between the US and Asian countries like China, what lessons and experiences from the US model might be worth adopting?
Prof. Sadia Khan: Yes. I think that in the United States, oncoplastic surgery was really born and popularized in Europe. The US was a little bit behind in that regard. The starting point for where oncoplastic surgery really emerged was the trials comparing mastectomy to breast conservation. Once we realized that women could do just as well with less surgery, the importance of cosmetic outcomes also started to gain popularity.
Some of the European surgeons influenced American surgeons, and the father of oncoplastic surgery in the United States is considered to be Melvin Silverstein. He is who I trained with as well. He and many other surgeons really popularized oncoplastic surgery as a main concept in the US.
Over the last ten years, I have seen a huge change and momentum for surgeons to be trained to offer oncoplastic breast surgery to the general community and to more patients. This growing popularity is seen not only in training programs that are incorporating oncoplastic surgery, but also at meetings and conferences, where there are many talks and courses. Organizations like the American Society of Breast Surgeons and other societies are putting on courses to allow surgeons who may not have trained in oncoplastics the opportunity to learn.
I see a similarity here in China. In major sites like Beijing and Shanghai, they are incorporating oncoplastic surgery, but there may not be as many opportunities for other regional hospitals and surgeons. I think something that could gain popularity here is that if not every program can offer it due to insufficient volume, surgeons could travel to high-volume sites. Alternatively, national leaders could offer courses to provide learning and experience. Incorporating this into training would obviously be the best way to achieve widespread adoption.
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《肿瘤瞭望》：众所周知，您非常重视构建一套全面的肿瘤整形外科医生培训课程。能否请您介绍一下您主导的培训项目？在美国，一名肿瘤整形外科医生的典型培训路径是怎样的？
Sadia Khan教授：目前，美国还没有一个标准化的肿瘤整形培训项目。ASBrS设有一个主要的乳腺肿瘤专科进修项目，为期约一年。各个培训项目中会涉及不同比例的肿瘤整形保乳手术内容，并且他们正在将其纳入标准化的教学课程中。不过，各医院在肿瘤整形方面的培训量差异很大。
为了推动培训的标准化，我们设立了一个独立的肿瘤整形乳腺外科进修项目，为期一年，面向所有已完成培训并获得专科认证的外科医生。不同资历的外科医生都可以参加这个为期一年的沉浸式进修项目，全面学习各种相关技术。
Oncology Frontier: As we all know, you have placed a particular emphasis on building a comprehensive curriculum for oncoplastic breast surgeons. Could you tell us about the oncoplastic surgery training program you lead? And what does the typical training pathway look like for oncoplastic breast surgeons in the US?
Prof. Sadia Khan: Yes. Currently, there is no standardized oncoplastic training program. The Surgical Society has a main breast oncology fellowship that lasts about one year. There is varied exposure to oncoplastic breast surgery throughout the programs, and they are incorporating it into the standardized teaching curriculum. However, the amount of oncoplastic exposure varies from hospital to hospital.
In an effort to allow for standardization, we have created a standalone oncoplastic breast fellowship that is one year long for any surgeon who is trained and board certified. Surgeons at various levels can participate in this fully immersive one-year fellowship, where they are trained in all of these techniques.
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《肿瘤瞭望》：能否请您分享一下此次中美学术交流的感受？您对中国在肿瘤整形保乳手术方面的进展总体印象如何？您认为，中国未来要在该领域取得突破和发展，需要在哪些关键方面发力？
Sadia Khan教授：这是我第一次访问中国，我的体验非常好。我参观了一些当地的医院，与这里的乳腺外科医生进行了交流，并参加了这次会议。中国的文化和医生们的友善热情给我留下了非常深刻的印象，同时他们的外科技能也让我十分赞叹。这里的医生训练有素，似乎正在开展许多令人惊叹的工作。在某些方面，比如机器人手术和内镜下乳房切除术，我认为他们甚至比美国的一些中心还要先进。
我感受到中国对于建立更多肿瘤整形乳腺外科进修项目和培训体系有着很强的驱动力，并且希望让更多外科医生接触到这些技术。我认为，未来的重点应该是找到一种方法来实现培训的标准化，让所有外科医生都能接受肿瘤整形保乳手术的培训，从而为广大中国女性患者提供这项服务。
Oncology Frontier: Could you share your impressions from the recent China-US academic exchange? What has been your overall impression of China's progress in oncoplastic breast surgery? And in your view, what are the key areas where China needs to focus its efforts for future breakthroughs and development?
Prof. Sadia Khan: Yes. This is my first visit to China, and I have had a wonderful experience visiting some local hospitals, meeting with breast surgeons here, and attending this conference. I have been very impressed with the culture and the kindness I have been shown, as well as the surgical expertise. Surgeons here are wonderfully trained and seem to be doing amazing things. In some aspects, such as robotics and endoscopic mastectomy, I think they are even more advanced than what we have in some parts of the US.
It sounds like there is a strong drive here to build more oncoplastic breast fellowships and training programs and to expose surgeons to these techniques. I think the focus should be on finding a way to standardize training and allow all surgeons to get education in oncoplastic breast surgery so that it can be offered to women throughout the community here.