Implications of Omitting Sentinel Lymph Node Biopsy in Patients Older Than 70 Years

To the Editor We read with great interest the article by Wang et al, wherein they reviewed 57 articles pertaining to the 4 low-value breast cancer (BC) operations defined by the Choosing Wisely campaign.¹ We commend the authors for presenting opportunities for deimplementation of low-value procedures to reduce health care waste. However, with regards to omission of sentinel lymph node biopsy (SLNB) in elderly patients with stage I, estrogen-receptor positive BC (ER+BC), there are important caveats to consider.