In this manner, upfront SLND may be avoided in all cases that may pose a dilemma, such as in, but not limited to, women older than aged 70 years with early-stage, hormone-positive, erbb2-negative breast cancer, as discussed in the Choosing Wisely recommendations.49 In the trial, this tailored approach, with review of final pathology at the postoperative multidisciplinary meeting and consideration of patient preference, allowed for 16.9% of patients with microinvasive/invasive breast cancer to avoid SLND. This evidence concerns the gene ERBB2 and breast cancer.