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Cirugía Española (English Edition) “Breast cancer with a good prognosis in elderly patients: is sentinel lymph no...
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Systematic review
Available online 11 June 2026

“Breast cancer with a good prognosis in elderly patients: is sentinel lymph node biopsy still justified?”

“Cáncer de mama de buen pronóstico en pacientes de edad avanzada: ¿Está aún justificada la biopsia del ganglio centinela?”
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Carlota López Domínguez
Corresponding author
carlotald95@gmail.com

Corresponding author.
, Alejandra García Novoa, Benigno Acea Nebril, Sergio Rodríguez Rojo, Aloia Guerreiro Caamaño
Unidad de Mama, Servicio de Cirugía General y Aparato Digestivo, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
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Abstract
Introduction

In older women with early-stage, hormone receptor-positive breast cancer, the value of sentinel lymph node biopsy (SLNB) has been questioned due to its limited prognostic and therapeutic impact.

Objective

To evaluate the usefulness of SLNB in this population.

Methods

A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Studies published between 2014 and 2024 were searched in PubMed, Cochrane Library, and Google Scholar, analyzing the impact of SLNB in women ≥60 years of age with cT1–T2N0, RH+, HER2– tumors undergoing primary surgery, and we performed a meta-analysis by subgroups focused on homogeneous domains.

Results

Of the 8,396 studies identified, 35 met the inclusion criteria. Omitting SLNB did not affect survival or increase recurrences, reducing the indication for adjuvant therapies.

Conclusion

In older women with low-risk early breast cancer, omitting SLNB is safe and does not compromise survival.

Keywords:
Sentinel lymph node biopsy
Breast cancer
Elderly
Axillary staging
Adjuvant treatment
Systematic review
Meta-analysis
Abbreviations:
ALND
CSS
CT
DFS
HR+
OS
RCT
RT
SLN
SLNB
Resumen
Introducción

En mujeres mayores con cáncer de mama precoz y receptores hormonales positivos, el valor de la biopsia del ganglio centinela (BGC) ha sido cuestionado por su escaso impacto pronóstico y terapéutico.

Objetivo

Evaluar la utilidad de la BGC en esta población.

Métodos

Efectuamos una revisión sistemática conforme a la guía PRISMA 2020. Se buscaron estudios publicados entre 2014–2024 en PubMed, Cochrane Library y Google Académico, que analizaban la implicación de la BGC en mujeres ≥60 años con tumores cT1–T2N0, RH+, HER2−, sometidas a cirugía primaria, y elaboramos un metaanálisis por subgrupos centrado en dominios homogéneos.

Resultados

De los 8.396 estudios identificados, 35 cumplieron los criterios de inclusión. La omisión de la BGC no afectó a la supervivencia ni aumentó las recurrencias, reduciendo la indicación de terapias adyuvantes.

Conclusión

En mujeres mayores con cáncer de mama precoz de bajo riesgo, la omisión de la BGC es segura y no compromete la supervivencia.

Palabras clave:
Biopsia del ganglio centinela
Cáncer de mama
Edad avanzada
Estadificación axilar
Tratamiento adyuvante
Revisión sistemática
Metaanálisis
Graphical abstract

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