老年乳腺癌患者是一个异质人群。研究表明，在某些临床情况下，省略前哨淋巴结活检（SLNB）可能是合适的，但三阴性乳腺癌（TNBC）患者通常被排除在这些研究之外。本研究根据 SLNB 收据和结果评估了老年 TNBC 患者的治疗和生存差异。 70 岁或以上诊断为 cT1-2/cN0/M0 TNBC（2010-2019 年）接受手术的患者选自国家癌症数据库。 Logistic 回归估计了 SLNB 与治疗的关联，Cox 比例风险模型估计了调整选定因素后 SLNB 与总生存 (OS) 的关联。 在研究纳入的 15,167 名患者中（中位年龄，77 岁），13.02%未接受 SLNB，5.14% 患有 pN1 疾病，0.12% 患有 pN2 疾病，0.01% 患有 pN3 疾病。大多数患者（83.9%）首先接受手术，16.1%接受新辅助化疗。在首先接受手术和 SLNB 的患者中，6.2% 患有 pN 疾病。无论 pN 状态如何，接受 SLNB 与化疗的较高可能性相关（比值比 [OR] 1.85；95% 置信区间 [CI] 1.55-2.21）。与未接受 SLNB 的患者相比，阴性 SLNB 与较低的死亡率显着相关（风险比 [HR] 0.68；95% CI 0.63-0.75），尽管阳性 SLNB 没有差异（HR 1.14；95%） CI 0.98-1.34）。根据 SLNB 接受或结果，首先接受化疗的患者的生存率没有差异 (p = 0.23)。大多数老年 TNBC 患者没有淋巴结受累，也没有接受化疗。 SLNB 的接受和结果可能与一些首先接受手术的人的结果相关，但与接受新辅助化疗的人无关。© 2024。外科肿瘤学会。

Older breast cancer patients represent a heterogeneous population. Studies demonstrate that sentinel lymph node biopsy (SLNB) omission may be appropriate in some clinical scenarios, yet patients with triple-negative breast cancer (TNBC) are often excluded from these studies. This study evaluated differences in treatment and survival for older patients with TNBC based on SLNB receipt and result.Patients 70 years old or older with a diagnosis of cT1-2/cN0/M0 TNBC (2010-2019) who underwent surgery were selected from the National Cancer Database. Logistic regression estimated the association of SLNB with therapy, and Cox proportional hazards models estimated the association of SLNB with overall survival (OS) after adjustment for select factors.Of the 15,167 patients included in the study (median age, 77 years), 13.02% did not undergo SLNB, 5.14% had pN1 disease, 0.12% had pN2 disease, and 0.01% had pN3 disease. Most of the patients (83.9%) underwent surgery first, and 16.1% received neoadjuvant chemotherapy. Of those who underwent surgery first and SLNB, 6.2% had pN+ disease. Receipt of SLNB was associated with a higher likelihood of chemotherapy (odds ratio [OR] 1.85; 95% confidence interval [CI] 1.55-2.21), regardless of pN status. Compared with those who did not undergo a SLNB, a negative SLNB was significantly associated with lower mortality (hazard ratio [HR] 0.68; 95% CI 0.63-0.75), although there was no difference for a positive SLNB (HR 1.14; 95% CI 0.98-1.34). The patients receiving chemotherapy first showed no difference in survival based on SLNB receipt or result (p = 0.23).Most older patients with TNBC do not have nodal involvement and do not receive chemotherapy. The receipt and results of SLNB may be associated with outcomes for some who undergo surgery first, but not for those who receive neoadjuvant chemotherapy.© 2024. Society of Surgical Oncology.