How would you treat a patient who had a previous mastectomy for an early stage breast cancer (without XRT) and then develops an isolated axillary recurrence and undergoes ALND?

There are no prospective studies to guide in this regard. Based on retrospective data, I would treat the chest wall, undissected axilla and supraclav area

I would treat comprehensively with chest wall radiation and regional nodal irradiation including SCV, axilla, and IM nodes.