The use of SNB in older patients has been questioned lately, and current recommendations advise that SNB in patients ≥ 70 years with early-stage, hormone receptor-positive, HER2-negative breast cancer and no palpable axillary lymph node treated with endocrine therapy can be considered individually with regard to its impact on radiation recommendations and systemic therapy decisions.28–30 A National Cancer Database study compared patients aged ≥ 70 years, with clinical negative axilla, where 99,764 patients underwent axillary surgery and 31,531 did not. Here, NR4A1 is linked to breast cancer.