CACA Guidelines for Holistic Integrative Management of Breast Cancer

Jiong Wu; Daiming Fan; Zhimin Shao; Binghe Xu; Guosheng Ren; Zefei Jiang; Yongsheng Wang; Feng Jin; Jin Zhang; Qingyuan Zhang; Fei Ma; Jinli Ma; Zhonghua Wang; Shusen Wang; Xiaojia Wang; Shu Wang; Haibo Wang; Tao Wang; Xiang Wang; Jing Wang; Jia Wang; Biyun Wang; Li Fu; Hongyuan Li; Yehui Shi; Lu Gan; Yunjiang Liu; Jian Liu; Zhenzhen Liu; Qiang Liu; Qiang Sun; Wenwu Cheng; Keda Yu; Zhongsheng Tong; Xinhong Wu; Chuangui Song; Jianguo Zhang; Jian Zhang; Junjie Li; Bin Li; Man Li; Huiping Li; Wentao Yang; Hongjian Yang; Benlong Yang; Hong Bu; Juping Shen; Zhenzhou Shen; Yiding Chen; Ceshi Chen; Da Pang; Zhimin Fan; Ying Zheng; Xiaoli Yu; Guangyu Liu; Xichun Hu; Yiqun Ling; Jinhai Tang; Yongmei Yin; Cuizhi Geng; Peng Yuan; Yajia Gu; Cai Chang; Xuchen Cao; Yuan Sheng; Yuanxi Huang; Jian Huang; Weijun Peng; Xiaohua Zeng; Yuntao Xie; Ning Liao; Committee of Breast Cancer Society, Chinese Anti-Cancer Association

doi:10.1007/s44178-022-00007-8

CACA Guidelines for Holistic Integrative Management of Breast Cancer

Holist Integr Oncol. 2022;1(1):7. doi: 10.1007/s44178-022-00007-8. Epub 2022 Jul 5.

Authors

Jiong Wu^{1

2}, Daiming Fan^{3

4}, Zhimin Shao^{1

2}, Binghe Xu⁵, Guosheng Ren⁶, Zefei Jiang⁷, Yongsheng Wang⁸, Feng Jin⁹, Jin Zhang¹⁰, Qingyuan Zhang¹¹, Fei Ma⁵, Jinli Ma^{2

12}, Zhonghua Wang^{1

2}, Shusen Wang¹³, Xiaojia Wang¹⁴, Shu Wang¹⁵, Haibo Wang¹⁶, Tao Wang¹⁷, Xiang Wang¹⁸, Jing Wang¹⁸, Jia Wang¹⁹, Biyun Wang^{2

20}, Li Fu^{21

22

23}, Hongyuan Li²⁴, Yehui Shi^{22

25

26

27}, Lu Gan²⁸, Yunjiang Liu²⁹, Jian Liu³⁰, Zhenzhen Liu³¹, Qiang Liu^{32

33}, Qiang Sun³⁴, Wenwu Cheng^{2

35}, Keda Yu^{1

2}, Zhongsheng Tong³⁶, Xinhong Wu³⁷, Chuangui Song³⁸, Jianguo Zhang³⁹, Jian Zhang^{2

20}, Junjie Li^{1

2}, Bin Li^{1

40}, Man Li⁴¹, Huiping Li⁴², Wentao Yang⁴³, Hongjian Yang⁴⁴, Benlong Yang^{1

2}, Hong Bu^{45

46}, Juping Shen^{1

2}, Zhenzhou Shen^{1

2}, Yiding Chen^{47

48}, Ceshi Chen^{49

50

51}, Da Pang⁵², Zhimin Fan⁵³, Ying Zheng^{2

54}, Xiaoli Yu^{2

55}, Guangyu Liu^{1

2}, Xichun Hu^{2

20}, Yiqun Ling^{2

56}, Jinhai Tang⁵⁷, Yongmei Yin⁵⁷, Cuizhi Geng⁵⁸, Peng Yuan⁵⁹, Yajia Gu^{2

60}, Cai Chang^{2

61}, Xuchen Cao^{22

26

27

62}, Yuan Sheng⁶³, Yuanxi Huang⁵², Jian Huang⁶⁴, Weijun Peng^{2

60}, Xiaohua Zeng⁶⁵, Yuntao Xie⁶⁶, Ning Liao⁶⁷; Committee of Breast Cancer Society, Chinese Anti-Cancer Association

Collaborators

Committee of Breast Cancer Society, Chinese Anti-Cancer Association:
Fan Daiming, Shao Zhimin, Xu Binghe, Ren Guosheng, Wu Jiong, Jiang Zefei, Wang Yongsheng, Jin Feng, Zhang Jin, Zhang Qingyuan, Ma Fei, Ma Jinli, Wang Zhonghua, Wang Yongsheng, Wang Shusen, Wang Xiaojia, Wang Shu, Wang Haibo, Wang Tao, Wang Xiang, Wang Jing, Wang Jia, Wang Biyun, Fu Li, Li Hongyuan, Shi Yehui, Gan Lu, Ren Guosheng, Liu Yunjiang, Liu Jian, Liu Zhenzhen, Liu Qiang, Cheng Wenwu, Jiang Zefei, Yu Keda, Tong Zhongsheng, Wu Xinhong, Song Chuangui, Zhang Jianguo, Zhang Jian, Zhang Qingyuan, Zhang Jin, Li Junjie, Li Bin, Li Man, Li Huiping, Yang Wentao, Yang Hongjian, Yang Benlong, Bu Hong, Shen Juping, Shen Zhenzhou, Shao Zhimin, Chen Yiding, Chen Ceshi, Pang Da, Fan Zhimin, Zheng Ying, Jin Feng, Yu Xiaoli, Liu Guangyu, Hu Xichun, Ling Yiqun, Tang Jinhai, Xu Binghe, Yin Yongmei, Geng Cuizhi, Geng Cuizhi, Geng Cuizhi, Yuan Peng, Gu Yajia, Chang Cai, Cao Xuchen, Sheng Yuan, Huang Yuanxi, Huang Jian, Huang Jian, Peng Weijun, Zeng Xiaohua, Xie Yuntao, Liao Ning

Affiliations

¹ Key Laboratory of Breast Cancer in Shanghai, Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College of Fudan University, Shanghai, China.
² Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China.
³ Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
⁴ State key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
⁵ National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁶ Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing China.
⁷ Medicine-Oncology, The Affiliated Hospital of Military Medical Sciences (The 307th Hospital of Chinese People's Liberation Army), Beijing, China.
⁸ Breast Disease Center, Shandong Cancer Hospital, Jinan, China.
⁹ Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
¹⁰ The 3rd Department of Breast Cancer, China Tianjin Breast Cancer Prevention, Treatment and Research Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin, China.
¹¹ Harbin Medical University Cancer Hospital, Harbin, China.
¹² Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College of Fudan University, Shanghai, China.
¹³ Sun Yat-Sen University Cancer Center, Guangzhou, China.
¹⁴ Zhejiang Cancer Hospital, Hangzhou, China.
¹⁵ Breast Center, Peking University People's Hospital, Beijing, China.
¹⁶ Department of Breast Center, The Affiliated Hospital of Qingdao University, Shandong, China.
¹⁷ Department of Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
¹⁸ Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
¹⁹ Department of Breast Surgery, Institute of Breast Disease, The Second Hospital of Dalian Medical University, Dalian, Liaoning China.
²⁰ Department of Medical Oncology, Fudan University Shanghai Cancer Centre, Shanghai, China.
²¹ Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
²² Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China.
²³ State Key Laboratory of Breast Cancer Research, Tianjin, China.
²⁴ Department of the Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
²⁵ Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
²⁶ Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
²⁷ Tianjin's Clinical Research Center for Cancer, Tianjin, China.
²⁸ Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²⁹ Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
³⁰ Department of Breast Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang China.
³¹ Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
³² Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
³³ Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
³⁴ Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
³⁵ Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.
³⁶ Department of Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
³⁷ Hubei Provincial Clinical Research Center for Breast Cancer, Department of Breast Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³⁸ Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
³⁹ Department of Breast Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China.
⁴⁰ Department of Nurse, Cancer Institute and Cancer Center, Fudan University, Shanghai, China.
⁴¹ The Second Affiliated Hospital of Dalian Medical University; Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China.
⁴² Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
⁴³ Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁴⁴ Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang China.
⁴⁵ Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHC, West China Hospital, Sichuan University, Chengdu, China.
⁴⁶ Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
⁴⁷ Department of Breast Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁴⁸ The Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Zhejiang University School of Medicine, Hangzhou, China.
⁴⁹ Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China.
⁵⁰ KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China.
⁵¹ Institute of Translation Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
⁵² Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China.
⁵³ Department of Breast Surgery, The First Bethune Hospital of Jilin University, Changchun, Jilin China.
⁵⁴ Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China.
⁵⁵ Department of Radiotherapy, Fudan University Shanghai Cancer Center, Shanghai, China.
⁵⁶ Department of Nutrition, Fudan University Shanghai Cancer Center, Shanghai, China.
⁵⁷ Department of Breast Cancer, Jiangsu Province Hospital, Nanjing, China.
⁵⁸ Department of Breast Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
⁵⁹ National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁶⁰ Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
⁶¹ Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, China.
⁶² The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
⁶³ Department of Breast Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
⁶⁴ Department of Breast Surgery, Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Cancer Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
⁶⁵ Breast Center, Chongqing Cancer Hospital, Chongqing University, Chongqing, China.
⁶⁶ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Center, Peking University Cancer Hospital & Institute, Beijing, China.
⁶⁷ Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China.

Abstract

Purpose: Breast cancer is now the most common malignant tumor worldwide. About one-fourth of female cancer patients all over the world suffer from breast cancer. And about one in six female cancer deaths worldwide is caused by breast cancer. In terms of absolute numbers of cases and deaths, China ranks first in the world. The CACA Guidelines for Holistic Integrative Management of Breast Cancer were edited to help improve the diagnosis and comprehensive treatment in China.

Methods: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to classify evidence and consensus.

Results: The CACA Guidelines for Holistic Integrative Management of Breast Cancer include the epidemiology of breast cancer, breast cancer screening, breast cancer diagnosis, early breast cancer treatment, advanced breast cancer treatment, follow-up, rehabilitation, and traditional Chinese medicine treatment of breast cancer patients.

Conclusion: We to standardize the diagnosis and treatment of breast cancer in China through the formulation of the CACA Guidelines.

Keywords: Advanced breast cancer treatment; Breast cancer diagnosis; Breast cancer screening; Early breast cancer treatment; Epidemiology of breast cancer; Traditional Chinese medicine treatment of breast cancer.