Further de-escalation is supported by the updated American Society of Clinical Oncology (ASCO) guidelines presented in 2021, stating that SLNB could be omitted altogether in women ≥ 70 years with cT1N0, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative BC, conditionally treated with adjuvant hormonal therapy [2]. This evidence concerns the gene ERBB2 and breast cancer.