{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T19:28:07Z","timestamp":1786390087671,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Sentinel lymph node biopsy (SLNB) is the standard approach for axillary staging in early breast cancer (BC), but the utility in older patients remains controversial. Several studies have demonstrated that omission of SLNB may be appropriate in patients with hormone receptor\u2010positive\/HER2\u2010negative tumors, but these analyses typically exclude those with triple\u2010negative (TN) and human epidermal growth factor receptor 2 (HER2)\u2010positive subtypes. The aim of this exploratory study is to generate preliminary data on current practice and the clinical utility of SLNB in women aged 70\u2009years or older with these higher\u2010risk subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective observational study including women aged \u2265\u200970\u2009years with TN or HER2\u2010positive BC and clinically node\u2010negative (cN0) axilla prior to upfront surgery (US) or after neoadjuvant chemotherapy (NAC), who underwent surgical treatment between 2014 and 2024 at a single institution. Patients were stratified according to SLNB performance. The clinical utility of SLNB was assessed by evaluating its impact on adjuvant chemotherapy indication, and the number needed to screen (NNS) was calculated. Five\u2010year cause\u2010specific mortality was described using Kaplan\u2013Meier estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 87 patients were included. SLNB was performed in 77% of cases (88% in the NAC group and 72.6% in the US group). Patients receiving NAC were younger and had fewer comorbidities, underscoring that well\u2011selected elderly patients can receive guideline\u2011concordant care. In the US cohort, women in whom SLNB was omitted were older (mean age, 88 vs. 76\u2009years). SLNB changed adjuvant chemotherapy recommendations in only 2 of 45 patients (4.4%), corresponding to an NNS of 23 (95% CI, 7\u201384). No increase in axillary recurrence or BC\u2010specific mortality was observed after SLNB omission. Patients in whom SLNB was omitted had a markedly higher 5\u2010year other\u2010cause mortality than those who underwent SLNB (35.3% vs. 8.9%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings of this study suggest that, in selected older patients with limited life expectancy, the clinical utility of SLNB may be limited, highlighting the need for individualized decision\u2010making regarding axillary staging. Larger studies are needed to better define the criteria for de\u2010escalating axillary staging in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70364","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:40:31Z","timestamp":1786387231000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sentinel Lymph Node Biopsy in Elderly Patients With Aggressive Breast Cancer Subtypes: Real\u2010World Clinical Utility and Treatment Implications"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5116-2771","authenticated-orcid":false,"given":"Daniel","family":"Otero\u2010Romero","sequence":"first","affiliation":[{"name":"Breast Unit, Department of Surgery Hospital Cl\u00ednico Lozano Blesa Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-4792","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Carrami\u00f1ana\u2010Nu\u00f1o","sequence":"additional","affiliation":[{"name":"Breast Unit, Department of Surgery Hospital Cl\u00ednico Lozano Blesa Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3592-820X","authenticated-orcid":false,"given":"Dolores","family":"Arribas\u2010del\u2010Amo","sequence":"additional","affiliation":[{"name":"Breast Unit, Department of Surgery Hospital Cl\u00ednico Lozano Blesa Zaragoza Spain"},{"name":"Department of Surgery, Faculty of Medicine University of Zaragoza Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/abs-21-89"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.3759"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2412063"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","unstructured":"M. L.Smidt R. J.Schipper V. M.Roozendaal van et al. \u201cOmission of Sentinel Lymph Node Biopsy in Clinically T1\u20102 Node\u2010Negative Breast Cancer Patients Treated With Breast\u2010Conserving Therapy: Results of the Dutch BOOG 2013\u201008 Randomized Controlled Trial After a Median Follow\u2010Up of 5 Years \u201d Supplement Clinical Cancer Research32 no. 4S: Abstract GS2\u201011 https:\/\/doi.org\/10.1158\/1557-3265.SABCS25-GS2-11.","DOI":"10.1158\/1557-3265.SABCS25-GS2-11"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35910"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2025.104641"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-023-03062-1"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4448-5"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30741-5"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2023.0264"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12123698"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.4048\/jbc.2025.0157"},{"key":"e_1_2_10_15_1","volume-title":"Breast Cancer (Version 1.2026) [Internet]","author":"National Comprehensive Cancer Network","year":"2026"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-16106-x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-15812-w"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-18417-z"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm15100501"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.70364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:40:33Z","timestamp":1786387233000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.70364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":18,"alternative-id":["10.1002\/jso.70364"],"URL":"https:\/\/doi.org\/10.1002\/jso.70364","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]},"assertion":[{"value":"2026-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jso.70364"}}