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The Lucerne Toolbox 2 to optimise axillary management for early breast cancer : a multidisciplinary expert consensus

Kaidar-Person, Orit ; Pfob, André ; Gentilini, Oreste Davide ; Borisch, Bettina ; Bosch, Ana LU ; Cardoso, Maria João ; Curigliano, Giuseppe ; De Boniface, Jana ; Denkert, Carsten and Hauser, Nik , et al. (2023) In EClinicalMedicine 61.
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Axillary management, Breast cancer, Consensus, Patient journey
in
EClinicalMedicine
volume
61
article number
102085
publisher
Lancet Publishing Group
external identifiers
  • pmid:37528842
  • scopus:85165682143
ISSN
2589-5370
DOI
10.1016/j.eclinm.2023.102085
language
English
LU publication?
yes
id
c43de617-0e53-4c9a-84b8-6ea1b3995e0d
date added to LUP
2023-12-22 10:19:25
date last changed
2024-04-20 19:38:28
@article{c43de617-0e53-4c9a-84b8-6ea1b3995e0d,
  abstract     = {{<p>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.</p>}},
  author       = {{Kaidar-Person, Orit and Pfob, André and Gentilini, Oreste Davide and Borisch, Bettina and Bosch, Ana and Cardoso, Maria João and Curigliano, Giuseppe and De Boniface, Jana and Denkert, Carsten and Hauser, Nik and Heil, Jörg and Knauer, Michael and Kühn, Thorsten and Lee, Han Byoel and Loibl, Sibylle and Mannhart, Meinrad and Meattini, Icro and Montagna, Giacomo and Pinker, Katja and Poulakaki, Fiorita and Rubio, Isabel T. and Sager, Patrizia and Steyerova, Petra and Tausch, Christoph and Tramm, Trine and Vrancken Peeters, Marie Jeanne and Wyld, Lynda and Yu, Jong Han and Weber, Walter Paul and Poortmans, Philip and Dubsky, Peter}},
  issn         = {{2589-5370}},
  keywords     = {{Axillary management; Breast cancer; Consensus; Patient journey}},
  language     = {{eng}},
  publisher    = {{Lancet Publishing Group}},
  series       = {{EClinicalMedicine}},
  title        = {{The Lucerne Toolbox 2 to optimise axillary management for early breast cancer : a multidisciplinary expert consensus}},
  url          = {{http://dx.doi.org/10.1016/j.eclinm.2023.102085}},
  doi          = {{10.1016/j.eclinm.2023.102085}},
  volume       = {{61}},
  year         = {{2023}},
}