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

Orit Kaidar-Person; André Pfob; Oreste Davide Gentilini; Bettina Borisch; Ana Bosch; Maria João Cardoso; Giuseppe Curigliano; Jana De Boniface; Carsten Denkert; Nik Hauser; Jörg Heil; Michael Knauer; Thorsten Kühn; Han Byoel Lee; Sibylle Loibl; Meinrad Mannhart; Icro Meattini; Giacomo Montagna; Katja Pinker; Fiorita Poulakaki; Isabel T. Rubio; Patrizia Sager; Petra Steyerova; Christoph Tausch; Trine Tramm; Marie Jeanne Vrancken Peeters; Lynda Wyld; Jong Han Yu; Walter Paul Weber; Philip Poortmans; Peter Dubsky

doi:10.1016/j.eclinm.2023.102085

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

Orit Kaidar-Person, André Pfob, Oreste Davide Gentilini, Bettina Borisch, Ana Bosch, Maria João Cardoso, Giuseppe Curigliano, Jana De Boniface, Carsten Denkert, Nik Hauser, Jörg Heil, Michael Knauer, Thorsten Kühn, Han Byoel Lee, Sibylle Loibl, Meinrad Mannhart, Icro Meattini, Giacomo Montagna, Katja Pinker, Fiorita PoulakakiIsabel T. Rubio, Patrizia Sager, Petra Steyerova, Christoph Tausch, Trine Tramm, Marie Jeanne Vrancken Peeters, Lynda Wyld, Jong Han Yu, Walter Paul Weber, Philip Poortmans, Peter Dubsky^*

^*Corresponding author for this work

Oncology

Research output: Contribution to journal › Review article › peer-review

12 Scopus citations

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.

Original language	English
Article number	102085
Journal	EClinicalMedicine
Volume	61
DOIs	https://doi.org/10.1016/j.eclinm.2023.102085
State	Published - Jul 2023

Funding

Funders	Funder number
Hirslanden Klinik St. Anna

Keywords

Axillary management
Breast cancer
Consensus
Patient journey

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.eclinm.2023.102085

Cite this

Kaidar-Person, O., Pfob, A., Gentilini, O. D., Borisch, B., Bosch, A., Cardoso, M. J., Curigliano, G., De Boniface, J., Denkert, C., Hauser, N., Heil, J., Knauer, M., Kühn, T., Lee, H. B., Loibl, S., Mannhart, M., Meattini, I., Montagna, G., Pinker, K., ... Dubsky, P. (2023). The Lucerne Toolbox 2 to optimise axillary management for early breast cancer: a multidisciplinary expert consensus. EClinicalMedicine, 61, Article 102085. https://doi.org/10.1016/j.eclinm.2023.102085

@article{731371299f944621a04b81a460b895a6,

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

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{\textquoteright} 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.",

keywords = "Axillary management, Breast cancer, Consensus, Patient journey",

author = "Orit Kaidar-Person and Andr{\'e} Pfob and Gentilini, {Oreste Davide} and Bettina Borisch and Ana Bosch and Cardoso, {Maria Jo{\~a}o} and Giuseppe Curigliano and {De Boniface}, Jana and Carsten Denkert and Nik Hauser and J{\"o}rg Heil and Michael Knauer and Thorsten K{\"u}hn and Lee, {Han Byoel} and Sibylle Loibl and Meinrad Mannhart and Icro Meattini and Giacomo Montagna and Katja Pinker and Fiorita Poulakaki and Rubio, {Isabel T.} and Patrizia Sager and Petra Steyerova and Christoph Tausch and Trine Tramm and {Vrancken Peeters}, {Marie Jeanne} and Lynda Wyld and Yu, {Jong Han} and Weber, {Walter Paul} and Philip Poortmans and Peter Dubsky",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = jul,

doi = "10.1016/j.eclinm.2023.102085",

language = "אנגלית",

volume = "61",

journal = "EClinicalMedicine",

issn = "2589-5370",

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Kaidar-Person, O, Pfob, A, Gentilini, OD, Borisch, B, Bosch, A, Cardoso, MJ, Curigliano, G, De Boniface, J, Denkert, C, Hauser, N, Heil, J, Knauer, M, Kühn, T, Lee, HB, Loibl, S, Mannhart, M, Meattini, I, Montagna, G, Pinker, K, Poulakaki, F, Rubio, IT, Sager, P, Steyerova, P, Tausch, C, Tramm, T, Vrancken Peeters, MJ, Wyld, L, Yu, JH, Weber, WP, Poortmans, P & Dubsky, P 2023, 'The Lucerne Toolbox 2 to optimise axillary management for early breast cancer: a multidisciplinary expert consensus', EClinicalMedicine, vol. 61, 102085. https://doi.org/10.1016/j.eclinm.2023.102085

TY - JOUR

T1 - The Lucerne Toolbox 2 to optimise axillary management for early breast cancer

T2 - a multidisciplinary expert consensus

AU - Kaidar-Person, Orit

AU - Pfob, André

AU - Gentilini, Oreste Davide

AU - Borisch, Bettina

AU - Bosch, Ana

AU - Cardoso, Maria João

AU - Curigliano, Giuseppe

AU - De Boniface, Jana

AU - Denkert, Carsten

AU - Hauser, Nik

AU - Heil, Jörg

AU - Knauer, Michael

AU - Kühn, Thorsten

AU - Lee, Han Byoel

AU - Loibl, Sibylle

AU - Mannhart, Meinrad

AU - Meattini, Icro

AU - Montagna, Giacomo

AU - Pinker, Katja

AU - Poulakaki, Fiorita

AU - Rubio, Isabel T.

AU - Sager, Patrizia

AU - Steyerova, Petra

AU - Tausch, Christoph

AU - Tramm, Trine

AU - Vrancken Peeters, Marie Jeanne

AU - Wyld, Lynda

AU - Yu, Jong Han

AU - Weber, Walter Paul

AU - Poortmans, Philip

AU - Dubsky, Peter

PY - 2023/7

Y1 - 2023/7

N2 - 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.

AB - 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.

KW - Axillary management

KW - Breast cancer

KW - Consensus

KW - Patient journey

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SN - 2589-5370

VL - 61

JO - EClinicalMedicine

JF - EClinicalMedicine

M1 - 102085

ER -

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

Abstract

Funding

Keywords

UN SDGs

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