In what circumstances would you offer axillary re-irradiation after salvage axillary dissection?

A study from many years ago found no further axillary recurrences in 4 patients who had gross total excision of axillary recurrences following initial breast-conserving therapy, including RT and axillary dissection, with a median follow-up of 28 months (Recht et al., PMID 2033433). However, there is...

This is a tough situation, but one that we encounter more often than we would like!

Although there have been studies examining conventional fractionation to 45-50 Gy in the re-irradiation setting [to the chest wall (post-mastectomy) and/or regional nodal regions], in the axillary re-irradiation setti...