Studies of elderly breast cancer patients have led to de-escalation of care, most notably the Choosing Wisely campaign, wherein the Society of Surgical Oncology stated in 2016, “Don’t routinely use sentinel lymph node biopsy in clinically node-negative women 70 years of age with hormone receptor-positive invasive breast cancer.”4 While there is strong evidence for treating breast cancer less aggressively in the elderly community without impact on survival, it remains to be seen if screening guidelines can also be relaxed in this patient population. This evidence concerns the gene NR4A1 and breast cancer.