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; Cardoso, Maria João; Curigliano, Giuseppe; Boniface, Jana de; Denkert, Carsten; Hauser, Nik; Heil, Jörg; Knauer, Michael; Kühn, Thorsten; Lee, Han‐Byoel; Loibl, Sibylle; Mannhart, Meinrad; Meattini, Icro; Montagna, Giacomo; Pinker, Katja; Poulakaki, Fiorita; Rubio, Isabel T.; Sager, Patrizia; Steyerová, Petra; Tausch, Christoph; Tramm, Trine; Peeters, Marie-Jeanne Vrancken; Wyld, Lynda; Yu, Jonghan; Weber, Walter; Poortmans, Philip; Dubsky, Peter

doi:10.1016/j.eclinm.2023.102085

eClinicalMedicine

2023

DOI: 10.1016/j.eclinm.2023.102085

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

Orit Kaidar‐Person

André Pfob

Oreste Davide Gentilini

et al.

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Cited by 8 publications

(2 citation statements)

References 74 publications

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“…Additionally, the choice of surgery should consider the best option for the patient without pushing the rope for excessively complex oncoplastic procedures, that in some cases can cause more harm than good. Speaking about the axilla we should stress the importance of evaluating the results of the AXSANA [ 36 ], NSABP B-51 [ 37 ] and ALLIANCE A11202 [ 38 ] trials, which are expected to shed light on the management of nodal areas in patients undergoing primary systemic therapy [ 39 ]. However, possibly in line with a lack of solid data, a recent international survey has worryingly demonstrated the wide heterogeneity of surgical and radiation procedures in patients with positive nodes converting to node negative status after systemic treatment [ 40 ].…”

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confidence: 99%

De-escalation of loco-regional treatments: Time to find a balance

Gentilini,

Cardoso,

Senkus

et al. 2024

The Breast

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confidence: 99%

De-escalation of loco-regional treatments: Time to find a balance

Gentilini,

Cardoso,

Senkus

et al. 2024

The Breast

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“…Considerations for RT in patients receiving preoperative systemic therapy according to the "Lucerne Toolbox"[27]. factors: non-luminal A-like, grade 3, middle/high genomic risk, LVI, ECE.…”

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confidence: 99%

The Role of Adjuvant Radiotherapy in the Treatment of Breast Cancer

Kolářová,

Melichar,

Sirák

et al. 2024

Current Oncology

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The role of postmastectomy radiotherapy and regional nodal irradiation after radical mastectomy is defined in high-risk patients with locally advanced tumors, positive margins, and unfavorable biology. The benefit of postmastectomy radiotherapy in intermediate-risk patients (T3N0 tumors) remains a matter of controversy. It has been demonstrated that radiotherapy after breast-conserving surgery lowers the locoregional recurrence rate compared with surgery alone and improves the overall survival rate. In patients with four or more positive lymph nodes or extracapsular extension, regional lymph node irradiation is indicated regardless of the surgery type (breast-conserving surgery or mastectomy). Despite the consensus that patients with more than three positive lymph nodes should be treated with radiotherapy, there is controversy regarding the recommendations for patients with one to three involved lymph nodes. In patients with N0 disease with negative findings on axillary surgery, there is a trend to administer regional lymph node irradiation in patients with a high risk of recurrence. In patients treated with neoadjuvant systemic therapy and mastectomy, adjuvant radiotherapy should be administered in cases of clinical stage III and/or ≥ypN1. In patients treated with neoadjuvant systemic therapy and breast-conserving surgery, postoperative radiotherapy is indicated irrespective of pathological response.

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Breast cancer: evaluating the axilla before, during, and after therapy—new challenges

Steyerova,

Kaidar-Person,

Pinker

et al. 2024

Eur Radiol

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

Cited by 8 publications

References 74 publications

De-escalation of loco-regional treatments: Time to find a balance

De-escalation of loco-regional treatments: Time to find a balance

The Role of Adjuvant Radiotherapy in the Treatment of Breast Cancer

Breast cancer: evaluating the axilla before, during, and after therapy—new challenges

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