{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:07:20Z","timestamp":1791360440601,"version":"4.3.1"},"reference-count":50,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T00:00:00Z","timestamp":1755993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Sentinel lymph node biopsy (SLNB) has traditionally been used to stage the axilla in early-stage breast cancer. However, its utility in women over 70 with hormone receptor-positive tumors and negative axillary imaging is increasingly questioned due to limited therapeutic benefit and potential complications. Objectives. To assess the feasibility of omitting SLNB in women aged 70 and older with clinically node-negative, luminal-type breast cancer. Methods: A retrospective analysis was conducted on women aged 70 and above with histologically confirmed invasive breast cancer, negative axillary imaging, and surgery between January 2021 and December 2024. Eligible patients were selected based on normal axillary ultrasound findings. All underwent SLNB. We examined demographics, clinical characteristics, surgical outcomes, and oncological variables such as recurrence and mortality. Results: A total of 149 women underwent surgery, with a mean age of 77.2 (5.24) years. SLNB was positive in 23.5% of cases, but only 6.7% required axillary dissection. Sensitivity and specificity of SLNB declined notably after age 76. No axillary or breast recurrences were reported. Most patients (89.9%) received hormonal therapy, while 11.4% had chemotherapy and 17.5% axillary radiotherapy. Outpatient management was feasible in 87.9% of cases, and no clinically significant lymphedema was observed. Conclusions: Omitting SLNB in women \u226570 years with luminal breast cancer and negative axillary imaging appears safe and does not compromise oncological outcomes. This strategy minimizes surgical risks and enhances quality of life, supporting a more tailored and less invasive approach to axillary management in older patients.<\/jats:p>","DOI":"10.3390\/cancers17172758","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:09:53Z","timestamp":1756080593000},"page":"2758","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of the Axilla in Older Patients with Breast Cancer: Reassessing the Role of Sentinel Lymph Node Biopsy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7386-2296","authenticated-orcid":false,"given":"Francisco","family":"Castillejos Ib\u00e1\u00f1ez","sequence":"first","affiliation":[{"name":"Breast Unit, Department of General and Digestive Surgery, Hospital Clinico Universitario of Valencia, Department of Surgery, University of Valencia, Biomedical Research Institute, INCLIVA. Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3201-8841","authenticated-orcid":false,"given":"Ernesto","family":"Mu\u00f1oz Sornosa","sequence":"additional","affiliation":[{"name":"Breast Unit, Department of General and Digestive Surgery, Hospital Clinico Universitario of Valencia, Department of Surgery, University of Valencia, Biomedical Research Institute, INCLIVA. Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"L\u00f3pez Flor","sequence":"additional","affiliation":[{"name":"Breast Unit, Department of General and Digestive Surgery, Hospital Clinico Universitario of Valencia, Department of Surgery, University of Valencia, Biomedical Research Institute, INCLIVA. Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7369-7361","authenticated-orcid":false,"given":"Marcos","family":"Adrianz\u00e9n Vargas","sequence":"additional","affiliation":[{"name":"Breast Unit, Department of General and Digestive Surgery, Hospital Clinico Universitario of Valencia, Department of Surgery, University of Valencia, Biomedical Research Institute, INCLIVA. Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1312-3555","authenticated-orcid":false,"given":"Mar\u00eda Teresa","family":"Mart\u00ednez Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Clinico Universitario of Valencia, Department of Medicine, University of Valencia, Biomedical Research Institute, INCLIVA. Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7800-9935","authenticated-orcid":false,"given":"Elvira","family":"Buch Villa","sequence":"additional","affiliation":[{"name":"Breast Unit, Department of General and Digestive Surgery, Hospital Clinico Universitario of Valencia, Department of Surgery, University of Valencia, Biomedical Research Institute, INCLIVA. Av. de Blasco Ib\u00e1\u00f1ez, 17, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2228524","DOI":"10.1001\/jamanetworkopen.2022.28524","article-title":"Assessment of Oncologists\u2019 Perspectives on Omission of Sentinel Lymph Node Biopsy in Women 70 Years and Older with Early-Stage Hormone Receptor-Positive Breast Cancer","volume":"5","author":"Minami","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_2","unstructured":"Sevensma, K.E., and Lewis, C.R. (2025). Axillary sentinel lymph node biopsy. 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