Would you re-irradiate the axilla after a resection for an isolated axilla recurrence in a breast cancer patient who had prior radiation to the breast and axilla?

I have, in the past, treated resected axilla recurrence with matted nodes/ECE where local recurrence risk was high and there was only partial overlap with the prior fields treated a few years prior. In those cases, I will include previously non-radiated nodal areas but not the breast/chest wall if i...

I would not retreat axilla if gross disease has been excised as morbidity would be too high and retrospective data shows axillary control may be good with excision alone (Recht et al JCO 1991). I would consider treating the undissected axilla and s/c if not treated with prior fields