Breast-Conserving Surgery & Reconstruction in Shanghai | Prof. Cai Fengfeng | CMCS

Breast-Conserving Surgery and Reconstruction — Balancing Cure and Quality of Life

For many women diagnosed with breast cancer, the prospect of losing a breast is as distressing as the diagnosis itself. Modern breast surgical oncology has evolved to offer patients a genuine choice: effective cancer removal combined with preservation or restoration of the breast. At Tongji Hospital in Shanghai, Prof. Cai Fengfeng leads a surgical program that places equal weight on oncological outcomes and long-term quality of life.

Featured Specialist: Prof. Cai Fengfeng (蔡丰丰)

Prof. Cai Fengfeng is a senior breast surgical oncologist at Tongji Hospital, Tongji University — one of Shanghai's established academic medical centers with a strong tradition in surgical oncology. Prof. Cai has developed deep expertise in the full spectrum of breast cancer surgical treatment, with a particular focus on:

• Breast-conserving surgery (BCS) — lumpectomy and wide local excision that removes the tumor while preserving the breast
• Oncoplastic breast surgery — combining cancer resection with plastic surgery techniques to reshape and restore the breast in a single operation
• Immediate breast reconstruction — performed at the time of mastectomy so patients wake with restored breast contour
• Delayed breast reconstruction — for patients who completed mastectomy previously and now wish to restore the breast
• Implant-based reconstruction — using tissue expanders and silicone implants
• Autologous (flap) reconstruction — using the patient's own tissue (TRAM, DIEP, latissimus dorsi flap) for a more natural result

Breast-Conserving Surgery: Who Is a Candidate?

Breast-conserving surgery is appropriate for many patients with early-stage breast cancer and is oncologically equivalent to mastectomy when combined with radiation therapy. Prof. Cai evaluates each patient individually based on:

• Tumor size relative to breast volume — smaller tumors in larger breasts are ideal candidates
• Tumor location — central or multifocal tumors may require modified approaches
• Response to neoadjuvant chemotherapy — tumor downstaging can convert patients from mastectomy to conservation candidates
• Margin status — clear surgical margins are essential; re-excision is performed if needed
• Patient preference — some patients prefer mastectomy for peace of mind; Prof. Cai respects and supports all informed choices
• Genetic risk (BRCA1/2) — carriers may opt for bilateral risk-reducing mastectomy with reconstruction

Oncoplastic Surgery: The Best of Both Worlds

Oncoplastic breast surgery is a specialized technique that integrates cancer surgery with plastic surgery principles — allowing larger tumors to be removed while maintaining or improving breast shape. Prof. Cai's oncoplastic approach includes:

• Volume displacement techniques: Reshaping remaining breast tissue to fill the defect after tumor removal
• Volume replacement techniques: Using local flaps to replace removed tissue when the remaining breast tissue is insufficient
• Therapeutic mammoplasty: Combining tumor excision with breast reduction for patients with larger breasts, often improving symmetry
• Contralateral symmetrization: Adjusting the opposite breast to match the treated side for optimal cosmetic outcome

Breast Reconstruction Options

For patients who require or choose mastectomy, Prof. Cai offers the full range of reconstructive options:

Implant-Based Reconstruction

• One-stage direct-to-implant reconstruction (immediate)
• Two-stage tissue expander followed by permanent implant
• Acellular dermal matrix (ADM) support for improved implant positioning
• Nipple-sparing mastectomy with implant reconstruction for eligible patients

Autologous (Own Tissue) Reconstruction

• DIEP flap (deep inferior epigastric perforator) — uses abdominal skin and fat without sacrificing the muscle; gold standard for natural results
• Latissimus dorsi flap — uses back muscle and skin; reliable and widely applicable
• TRAM flap — transverse rectus abdominis myocutaneous flap for patients with adequate abdominal tissue

Why Quality of Life Matters in Breast Cancer Surgery

Research consistently shows that body image, sexual wellbeing, and psychological recovery are significantly affected by the type of breast surgery a patient undergoes. Prof. Cai's philosophy recognizes that:

• Breast-conserving surgery is associated with better body image and sexual satisfaction compared to mastectomy without reconstruction
• Immediate reconstruction reduces the psychological burden of mastectomy
• Symmetry between the two breasts is an important factor in long-term satisfaction
• Patient involvement in surgical decision-making improves outcomes and reduces regret

How CMCS Coordinates Your Care

China Medical Concierge Shanghai (CMCS) is a health management company — not a hospital. We connect international patients with Shanghai's leading breast surgeons, including Prof. Cai Fengfeng at Tongji Hospital, and manage every step of the process:

• Review of existing imaging, biopsy results, and pathology reports
• Surgical consultation scheduling with Prof. Cai's team
• Coordination with medical oncology for neoadjuvant chemotherapy planning if applicable
• Coordination with radiation oncology for post-operative radiotherapy
• Medical interpretation during pre-operative consultations and post-operative follow-up
• Logistics support: accommodation near Tongji Hospital, visa assistance, and local transport
• Post-surgical follow-up and remote monitoring coordination

Get in Touch

If you are considering breast-conserving surgery, mastectomy with reconstruction, or oncoplastic breast surgery in Shanghai, contact our team for a confidential consultation.

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