{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:06:24Z","timestamp":1779789984299,"version":"3.53.1"},"reference-count":20,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Choosing Wisely Guidelines recommend against routine sentinel lymph node biopsy (SLNB) for early-stage, hormone-receptor positive (HR+), clinically node negative (cN0) breast cancer (BC) in elderly women. To determine the applicability of this guideline to men, we evaluated pathologic nodal positivity (pN+) between men and women with low-risk HR+, cN0 BC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Cancer Database was queried for patients \u226570\u00a0years who underwent surgical resection for low-risk, HR+, cN0 BC. Low-risk was defined as grade 1, cT1mi-T1c or grade 2, or cT1mi-T1b. pN+ was evaluated and compared by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 708 men and 123\u00a0855 women, 13.0% of men were pN+ compared to 7.7% of women (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Men presented with older age, more comorbidities, advanced stage, lymphovascular invasion, tumor upstaging, and a higher nodal burden (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Men were more likely to undergo axillary lymph node dissection (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), but there were no differences in adjuvant chemotherapy or endocrine therapy between pN+ men and women. There were no differences in 5-year overall survival (84.0% vs 85.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.80).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Men \u226570\u00a0years with low-risk cN0 breast cancer have nearly double the rate of nodal positivity compared with women, indicating that SLNB omission cannot be directly extrapolated from female-based guidelines and should instead be considered on an individualized basis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261416093","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:56:02Z","timestamp":1767898562000},"page":"1956-1963","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Nodal Positivity in Men 70 Years of Age and Older With Clinically Node Negative Hormone-Receptor Positive Breast Cancer to Guide Axillary Intervention"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4599-6676","authenticated-orcid":false,"given":"Sarah W.","family":"Yuen","sequence":"first","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5146-5006","authenticated-orcid":false,"given":"Shaina","family":"Sedighim","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avneet K.","family":"Bhullar","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy B.","family":"Tran","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari J.","family":"Kansal","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen T.","family":"Lane","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin H.","family":"Lin","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly M.","family":"Yong","sequence":"additional","affiliation":[{"name":"University of California Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2009.04.003"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2006.06.014"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.19.00792"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-021-03190-7"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2018.06.013"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/cjp2.106"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-020-02920-7"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/srep45293"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118957"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2953"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70207-2"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181f08f32"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.06.041"},{"key":"e_1_3_4_15_2","unstructured":"Society of Surgical Oncology. Choosing wisely. Published online July 12 2016. https:\/\/www.choosingwisely.org\/clinician-lists\/sso-sentinel-node-biopsy-in-node-negative-women-70-and-over\/"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.00934"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.5.1442"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2021.151794"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32668"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-5932-1"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.3759"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261416093","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261416093","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261416093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:48:11Z","timestamp":1779788891000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261416093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/00031348261416093"],"URL":"https:\/\/doi.org\/10.1177\/00031348261416093","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]}}}