Would you recommend definitive local treatment of locally recurrent breast cancer with a positive contralateral axillary lymph node and no signs of distant metastasis?  

Locally recurrent breast cancers are known to have aberrant nodal spread, including the contralateral axilla, because of previous axillary dissection and radiation. We treat these patients as locoregional disease with a combination of locoregional and systemic treatment. You do take previous treatm...

Obviously, similarities in histology to the original offer clues to what's going on here.  In the absence of glaring metastatic disease, I would give the patient the benefit of the doubt.  I'd manage the recurrent side based on previous treatment (e.g.: mastectomy for in-breast recurrence,...