Would you treat regional nodes in a patient with complete pathologic response on axillary dissection after neoadjuvant chemo for isolated axillary recurrence?

I would treat, in these cases. In terms of volumes, it depends on the time from the first course of RT.

If >5 years from RT, I tend to retreat nodes and breast/chest giving 50/25 to nodal regions and 45/25 to breast/chest wall.

If <5 years, I consider treating regional nodes (axilla, SCV) only.

For a stage 1 patient treated with BCT and SLNB, isolated axillary recurrence is most likely a rare manifestation of false-negative sentinel node (2-3%). The timeline for this recurrence is most likely a function of phenotype with delayed recurrence in ER-positive disease. In the modern era, whether...