Scientific publications

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

Jul 14, 2023 | Magazine: EClinicalMedicine

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