《卢塞恩工具箱2：早期乳腺癌腋窝管理的最优化策略：多学科专家共识》
The Lucerne Toolbox 2 to optimise axillary management for early breast cancer: a multidisciplinary expert consensus.
发表日期：2023 Jul
作者：
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
来源：
Experimental Hematology & Oncology
摘要：
早期乳腺癌的临床腋窝淋巴结管理已从仅仅是外科管理的一个方面发展到包括整个多学科团队。欧洲癌症学会和患者代表的多学科合作组织“Lucerne Toolbox”的第二版解决了临床腋窝淋巴结管理的挑战，从诊断到腋窝的局部治疗。根据患者的旅程制定了五个工作包，针对特定的临床情景进行讨论。评委在72个陈述中投票表决，达成共识（75%或更多的一致）的比例为52.8%，大多数人同意（51%-74%的一致）的比例为43.1%，没有决定的比例为4.2%。根据投票结果，有针对性的影像学检查和标准化的淋巴结病理学应作为计划局部和全身治疗的先决条件，多数情况下可以用哨兵淋巴结活检（加上有针对性的方法）取代腋窝淋巴结清扫；积极的患者结果应该由低复发风险和低淋巴水肿发生率共同驱动。© 2023 The Author(s).
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.© 2023 The Author(s).