Clinical practice guidelines for prognosis and follow-up of early-stage breast cancer patients: Chinese Society of Breast Surgery (CSBrS) practice guidelines (2026 edition) Chinese Society of Breast Surgery, Chinese Society of Surgery, Chinese Medical Association.

BACKGROUND

Long-term survival in early-stage breast cancer patients has markedly improved, making follow-up an increasingly prolonged phase of care. Accurate prognosis assessment and a scientifically grounded follow-up plan are essential for achieving effective and individualized chronic disease management. This guideline aims to standardize these practices in China.

METHODS

The Chinese Society of Breast Surgery (CSBrS) convened a panel of experts. Clinical evidence was assessed according to a modified GRADE system. Recommendations were developed by integrating evidence quality with practical feasibility in the Chinese healthcare setting. A consensus voting committee of 33 breast surgeons graded the recommendation strength (Level A: ≥90% agreement; Level B: 80-89% agreement).

RESULTS

This guideline centers on two core components: prognosis and follow-up. A comprehensive prognosis integrates four domains: patients' general health, including age, genetic risk, reproductive history, and past medical history; tumor staging and histopathological characteristics; molecular features like subtype, Ki-67, BRCA mutations, and multigene assay results; and treatment factors, notably surgical margin status and adjuvant regimens. Follow-up recommendations visit frequency started with every 3-6 months, then 6-12 months, transitioning to annual lifelong checks, with adjustments based on risk. Evaluations should cover general examination, tumor-related examinations, special examinations, assessment of psychosocial well-being and treatment-related complications. Implementing a structured single-disease database is also advised to support continued care and research.

CONCLUSIONS

This guideline provides evidence-based, consensus-driven recommendations for the prognostic evaluation and follow-up of early-stage breast cancer patients in China. Adopting this guideline within a multidisciplinary, patient-centered framework is vital for enhancing long-term survival and quality of life.