What is your practice regarding axillary isolated recurrence after surgery when a patient received previous whole breast radiation?

I agree with @Dr. First Last on both counts. In the case of a deep, isolated, axillary recurrence, we start with NeoCT (based on the CALOR Trial data).

Now, let's assume the patient has had prior comprehensive radiotherapy (breast and nodal), and now has smaller, but persistent isolated axillary dise...

This is a difficult question. If the patient has not received radiation to the regional LN's, I will certainly treat her. If she has, I would not treat her with RT and hope for the best.

Having pCR in the axilla will give probably better clinical outcomes, but will not alter my decision to treat the...