How would you manage the axilla of a patient with a recurrent ipsilateral breast cancer treated with lumpectomy, sentinel node biopsy, and IORT?

Generally, I am unenthusiastic about reirradiation of breast cancer patients who've been treated with BCT. Even if one can avoid critical structures such as heart and lungs, brachial plexus, etc. Cosmesis is likely to be compromised, given sufficient length of follow-up. In this instance, presumably...

There is a presumption also here that the patient had an axillary surgery at the original diagnosis > 10 years ago, as it was the standard of care. If this were the case one could question the merits of another axillary surgery on top of a previous AXLND vis-a-vis the risk of lymphedema. A micromet ...