Would you recommend ALND or sentinel node re-mapping in a patient with recurrent breast cancer of the areola complex who had previous nipple-sparing mastectomy and SLNB and no previous radiation?

The extent of axillary surgery in general, and also in the setting of locally recurrent disease with a clinically-negative axilla, has lessened over time, largely to try to mitigate arm morbidity. In the past, if a patient had a prior SLNB at the time of the original diagnosis, it was not uncommon t...

I typically have a discussion with patient and surgeon with factors including the features of the recurrence (receptor, grade, LVSI), patient factors, and technical factors as well as discussion of risk of lymphedema. Additionally, I like to have complete axillary imaging as well to guide the discus...

Remapping can be attempted but likelihood of finding node is low in practical world (although some series could be close to 60 to 70 percent)

If imaging negative favor RT as part of regional node RT