Oncology Frontier: Dr. Clough， of your many specialties， oncoplastic surgery is something that is not widely known but you are an expert to speak about that. Can you explain what that is?

　　《肿瘤瞭望》：在您的很多专长中，整形手术还不太广为人知。作为这方面的专家，能否请您给大家介绍和解释一下肿瘤整形手术？

　　Dr. Clough: Oncoplastic surgery are surgical techniques that have been prescribed for breast cancer patients in order to avoid a mastectomy when the tumor is large. What we do is we perform a wide excision of the tumor and with the remaining breast volume， we reshape a breast without an implant， without a flap， like a breast reduction technique. The advantage of that technique is that it allows patients who are candidates for a mastectomy due to the size of the tumor， who have large breasts， to be spared a mastectomy， and to have a breast reduction instead. The breast which has been carrying the cancer has radiotherapy and then most of the cases， the contralateral breast will get the breast reduction in order to symmetrize the breasts. We have been demonstrating that in France， on a national surgery， 10% of breast conservation patients are proposed oncoplastic surgery and this is why in France， with other techniques， is one of the leaders in breast conservation rates. Our national breast conservation rate is 72%， in France only 28% choose a mastectomy. Oncoplastic surgery is one of the tools we are using to increase breast conservations. The two countries that develop these operations in the late 1980s were Germany and France and we published quite a lot. The first surgeons who were trained to do oncoplastic surgeons were in Europe; Germany， France， and now England. England now is the leading country in surgeons being trained in dual specialties.

　　Clough教授：肿瘤整形手术是一种可用于在乳腺癌患者肿瘤较大时避免乳房切除术的外科治疗技术。进行该手术时，我们需要对肿瘤进行广泛切除，并利用剩下的乳房组织在不应用假体、皮瓣的情况下进行乳房重塑，有点类似于乳房缩小术。该技术的优点在于能使那些乳房较大且肿瘤大小达到乳房切除术标准的患者得以进行乳房缩小而不必进行乳房切除术。伴有癌症的乳房进行放疗后，为了保持双侧乳房对称，大部分情况下对侧乳房也需进行乳房缩小术。我们已发现，在法国，10%的保乳治疗患者会进行肿瘤整形术，正是因为该技术与其他技术的应用，法国的乳腺保乳治疗率才得以维持较高水平。法国的保乳治疗率达72%，仅有28%的患者选择乳房切除术。肿瘤整形手术是我们增加保乳治疗率的工具之一。二十世纪80年代末，德国与法国发明了这些手术，我们发表了很多这方面的文章。欧洲的德国、法国及目前英国率先培训了第一批肿瘤整形外科医生。英国现在已成为双重专长肿瘤整形手术培训领域的领先国家。