Scientific publications
The Lucerne Toolbox 2 to optimise axillary management for early breast cancer: a multidisciplinary expert consensus. Scientific Publication
Orit Kaidar-Person 1 2 3 , André Pfob 4 5 , Oreste Davide Gentilini 6 , Bettina Borisch 7 , Ana Bosch 8 9 , Maria João Cardoso 10 , Giuseppe Curigliano 11 12 , Jana De Boniface 13 14 , Carsten Denkert 15 , Nik Hauser 16 , Jörg Heil 4 17 , Michael Knauer 18 , Thorsten Kühn 19 , Han-Byoel Lee 20 21 , Sibylle Loibl 22 23 , Meinrad Mannhart 24 , Icro Meattini 25 26 , Giacomo Montagna 27 , Katja Pinker 28 , Fiorita Poulakaki 29 , Isabel T Rubio 30 , Patrizia Sager 31 , Petra Steyerova 32 , Christoph Tausch 33 , Trine Tramm 34 , Marie-Jeanne Vrancken Peeters 35 , Lynda Wyld 36 , Jong Han Yu 37 , Walter Paul Weber 38 39 , Philip Poortmans 40 41 , Peter Dubsky 42 43
Abstract
Clinical axillary lymph node management in early breast cancer has evolved from being merely an aspect of surgical management and now includes the entire multidisciplinary team.
The second edition of the "Lucerne Toolbox", a multidisciplinary consortium of European cancer societies and patient representatives, addresses the challenges of clinical axillary lymph node management, from diagnosis to local therapy of the axilla.
Five working packages were developed, following the patients' journey and addressing specific clinical scenarios. Panellists voted on 72 statements, reaching consensus (agreement of 75% or more) in 52.8%, majority (51%-74% agreement) in 43.1%, and no decision in 4.2%.
Based on the votes, targeted imaging and standardized pathology of lymph nodes should be a prerequisite to planning local and systemic therapy, axillary lymph node dissection can be replaced by sentinel lymph node biopsy ( ± targeted approaches) in a majority of scenarios; and positive patient outcomes should be driven by both low recurrence risks and low rates of lymphoedema.
CITATION EClinicalMedicine. 2023 Jul 14;61:102085. doi: 10.1016/j.eclinm.2023.102085
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