Optimizing the axillary management in breast cancer: from imaging to surgery

This thesis aimed to provide insights into different aspects of the axillary management of breast cancer patients: optimizing the axillary lymph node staging with non-invasive imaging modalities, a prediction of axillary pathologic complete response (pCR) based on the breast tumour response, an overview of axillary pCR rates for different breast cancer subtypes for de-escalation and escalation of treatment, and the implications of axillary response for the indication of post-mastectomy radiation therapy and the timing of breast reconstruction.

Part I of this thesis focused on optimizing the axillary lymph node staging by non-invasive imaging modalities in the preoperative setting and following neoadjuvant systemic therapy. Part II of this thesis focused on the prediction of axillary pCR following neoadjuvant systemic therapy for different breast cancer subtypes. Part III of this thesis focuses on the implications of residual axillary lymph node disease following neoadjuvant systemic therapy for post-mastectomy radiation therapy and immediate breast reconstruction.