Jacky Luiten

Valorization | 145 V grade invasive cancer. 14,15 . Furthermore, our study justifies repeated screening, as in every subsequent screening round new and clinically relevant abnormalities are detected. This thesis also addresses the risk of overdiagnosis and subsequent overtreatment associated with screening, by creating awareness of the trends in invasive diagnostics procedures and their outcome in women with a breast abnormality found at screening mammography. Our data suggest that it is safe omit invasive diagnostic interventions, such as secondary excision biopsies, which should only be considered if radiologic surveillance and repeated percutaneous biopsy continue to yield indeterminate results. Furthermore, there are growing concerns about the increasing trend of recall for suspicious microcalcifications, which is accompanied with a growing number of recalled women with benign pathology. Therefore, invasive diagnostic intervention for microcalcifications should be considered carefully and preference should be given to radiologic surveillance if possible. In the treatment of DCIS, this thesis shows that the trend of additional radiotherapy following breast conserving surgery (BCS) is decreasing. A more restrictive use of invasive diagnostic procedures and therapeutic interventions such as radiotherapy will not only reduce the physical and psychological burden for the patients, but it will also reduce healthcare costs. Target audience This thesis targets a broad audience as it contains valuable information for all members of the multidisciplinary tumor board, namely surgeons, radiologists, medical oncologists, pathologists, radiotherapists and other specialists such as general practitioners (who will eventually perform follow ‐ up of these patients). This thesis attempts to contribute to the discussion in the multidisciplinary tumor board to more often refrain from invasive interventions instead of following the motto ‘better be safe than sorry’. Omitting invasive unnecessary diagnostic or therapeutic interventions prevents avoidable morbidity. Furthermore, patients undergoing BCS for non ‐ palpable disease will benefit from new localization methods, such as iodine ‐ 125 guided localization, which proved to be as accurate as wire ‐ guided localization, but is reported as more patient friendly, less painful and has logistic advantages 16 ‐ 19 . The future As for this moment, predicting which pre ‐ malignant lesions will regress and which will proceed to invasive breast cancer is almost impossible. For that reason, most