Limited impact of sentinel lymph node biopsy in older women with cT2N0 hormone-positive human epidermal growth factor receptor 2-negative breast cancer.

Authors

Mariam T Khan, G Paul Wright, Jessica Thompson

Published in

Surgery. Pages 110626. Sep 03, 2026. Epub Sep 03, 2026.

Abstract

Consensus guidelines support selective omission of sentinel lymph node biopsy for axillary staging in older women with early stage, biologically favorable breast cancer; however, applicability to clinical T2 disease remains unclear. We evaluated the impact of sentinel lymph node biopsy on adjuvant treatment decisions in women ≥65 years with cT2N0 hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer.
A single-institution retrospective review included consecutive patients treated from 2019 to 2023. Clinicopathologic features, adjuvant therapy decisions, and outcomes were analyzed.
Among 113 patients, 35 (31%) had pN1 disease, and 2 (1.8%) had pN2-3 disease. Final pathologic tumor size was pT1 in 25 patients (22.1%), 2.1-3.0 cm in 48 (42.5%), 3.1-4.0 cm in 27 (23.9%), and >4.0 cm in 13 (11.5%). Nodal positivity was lower among patients with pT1 compared with pT2 tumors (8% vs 31%, P = .035) but did not differ across pT2 subgroups (P = .864). Twelve patients (10.6%) received chemotherapy, with nodal status determining treatment in only 2 cases. Regional nodal irradiation was administered to 15 of 37 patients with pathologically node-positive disease and omitted in the remainder. At the median follow-up of 3.1 years, 9 patients (8%) experienced recurrence; all pathologically node-positive patients with recurrence (n = 4) demonstrated endocrine therapy noncompliance.
In women ≥65 years with cT2N0 hormone receptor-positive/human epidermal growth factor receptor-negative breast cancer, sentinel lymph node biopsy infrequently influenced adjuvant management. Chemotherapy was guided by genomic assays, and most patients with pathologically node-positive disease did not receive regional nodal irradiation, supporting a selective, individualized approach to axillary staging.

PMID:
42810879
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.