Picture from the thesis of Pacific yew tree (taxus brevifolia). The tree bark contains cytotoxic compounds that are commonly used to treat breast cancer. Published with kind permission from Chris Earle.

Kian Chin: Improving breast cancer surgery after chemotherapy

Published

17 December 2025

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How can breast cancer surgery be optimized when chemotherapy is given first? Kian Chin’s research explores new ways to reduce infections, guide surgery more precisely, and tailor treatment to each patient.

Kian Chin, breast cancer surgeon at Sahlgrenska University Hospital and doctoral student at the Institute of Clinical Sciences.

KIAN CHIN
Dissertation defense: 23 January 2026 (click for details)
Doctoral thesis: Advancing surgical strategies for breast cancer in the era of neoadjuvant chemotherapy
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences

Many patients with certain types of breast cancer receive chemotherapy before surgery –neoadjuvant chemotherapy (NACT). Because chemotherapy alters the tumor’s appearance and biology and patients’ immune system, surgery can become more challenging. Kian Chin investigates how surgical outcomes can be improved in this setting.

Challenges after chemotherapy

Breast cancer is one of the most common cancers, affecting one in nine women. As NACT has become more widely used, it has raised new questions about how to perform safe and accurate surgery after the tumor has changed in size, shape, and characteristics.

“My doctoral thesis focused on how we can improve the outcome of breast cancer surgery after chemotherapy,” says Kian Chin, breast cancer surgeon at Sahlgrenska University Hospital, and doctoral student at the Institute of Clinical Sciences.

Figure from the thesis showing different patterns of tumor shrinkage following neoadjuvant chemotherapy. pCR indicates that there is complete tumor response where the cancer is no longer present after preoperative chemotherapy.

Improving surgical safety and precision

The thesis consists of four projects examining surgical outcomes from different angles. One project investigated how to reduce postoperative infections through standardized measures during surgery.

“Simple steps such as wound irrigation, antimicrobial sutures, wound glue as dressings, and infiltration of local anesthetics can reduce infections and allow patients to go home the same day,” he says.

Another project explored whether the immune environment of the tumor can predict how well chemotherapy will work.

“Patients with many immune T-cells in their tumor before treatment are more likely to have an excellent response, which may allow us to avoid more aggressive surgery in the armpit and reduce arm problems later.”

Figure from the thesis: Two different methods for localizing breast cancer. A: a conventional wire that protrudes through the skin. B: a small 5 mm magnetic seed inside the breast.

Better tools for finding targets

The research also tested new techniques to increase surgical accuracy.

“A small magnetic marker can locate the tumor precisely after chemotherapy and may be more comfortable for patients. We also found that marking important lymph nodes before chemotherapy may be more accurate than doing so afterwards, which can improve staging and guide treatment choices after surgery.”

Working across disciplines

What has been rewarding and challenging about your doctoral project?
“Modern breast cancer care requires close collaboration across specialties. It has been rewarding to learn from colleagues across the multidisciplinary team, all working toward better patient care,” says Kian Chin, and continues:

“Although coordinating different disciplines can be challenging, these experiences have strengthened my understanding of what it means to be a surgeon in a truly collaborative setting.”

Text: Jakob Lundberg

Area

Health and medicine