Factors that were associated with a higher chance of ALND performance were age < 40 years (OR 1.28; 95% CI 0.96–1.70) compared with age 50-59 years, lobular (OR 1.23; 95% CI 1.05–1.43) compared with ductal tumor type, basal-like (OR 1.83; 95% CI 1.33–2.53) compared with hormone receptor-positive (HR+)/HER2 receptor-negative tumor subtype, receiving chemotherapy (OR 2.34; 95% CI 1.98–2.77) compared with not receiving adjuvant chemotherapy, as well as treatment outside an academic institution (teaching hospital: OR 2.19; 95% CI 1.71–2.81, general hospital: OR 1.58; 95% CI 1.25–2.00) (Table 2). Here, NR4A1 is linked to neoplasm.