{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T04:59:52Z","timestamp":1769662792061,"version":"3.49.0"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chest wall recurrence can occur infrequently after mastectomy in breast cancer patients. While wide excision of chest wall recurrence is indicated in operable patients without metastasis elsewhere, management of the axilla remains controversial. We reviewed the literature to determine the role of axillary staging in patients with a preoperative diagnosis of isolated chest wall recurrence. Materials and Methods: A PubMed search was performed for relevant articles dated between 1 January 2000 and 31 December 2024. Only English articles comprising female patients with invasive chest wall recurrence after mastectomy were included. Patients with concomitant metastasis elsewhere, no operation for recurrence and no oncological outcomes were excluded. The outcomes were compared between patients with or without axillary staging during recurrence. Results: A total of 15 studies with 485 eligible patients were analyzed. Of these patients, 242 (49.9%), 182 (37.5%), 53 (10.9%), and 8 (1.6%) patients had sentinel lymph node biopsy (SLNB), no axillary surgery, failed SLNB, and upfront axillary lymph node dissection (ALND), respectively, for restaging. Among operated patients with reported axillary status, 33\/231 (14.3%) had metastatic nodes on axillary staging. On follow-up of 38.2 months (range: 10\u201361.2), 101\/485 (20.8%) patients developed a second recurrence, of which 16\/447 (3.6%) developed ipsilateral axillary recurrence. Ipsilateral axillary recurrence among patients with and without axillary surgery was 12\/182 (6.6%) and 4\/265 (1.5%), respectively. Conclusions: Ipsilateral axillary recurrence was low in patients with or without axillary restaging on medium-term follow-up. Due to the heterogeneity of the studies, larger studies with longer follow-up periods are needed to determine the best management for the axilla.<\/jats:p>","DOI":"10.3390\/medicina62020273","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:56:12Z","timestamp":1769615772000},"page":"273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Axillary Restaging in Breast Cancer Patients with Preoperative Diagnosis of Isolated Chest Wall Recurrence After Mastectomy: A Literature Review"],"prefix":"10.3390","volume":"62","author":[{"given":"Ni\u00f1a Xiamina","family":"Alger-Turrecha","sequence":"first","affiliation":[{"name":"Breast Department, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa Ying Zhen","family":"Tan","sequence":"additional","affiliation":[{"name":"Breast Department, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5296-3437","authenticated-orcid":false,"given":"Geok Hoon","family":"Lim","sequence":"additional","affiliation":[{"name":"Breast Department, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"},{"name":"Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2965","DOI":"10.1007\/s11845-024-03809-z","article-title":"Risk of locoregional recurrence after breast cancer surgery by molecular subtype-a systematic review and network meta-analysis","volume":"193","author":"Nolan","year":"2024","journal-title":"Ir. J. Med. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"468","DOI":"10.11622\/smedj.2014115","article-title":"Syndecan-1 is a potential biomarker for triple-positive breast carcinomas in Asian women with correlation to survival","volume":"55","author":"Lim","year":"2014","journal-title":"Singap. Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1245\/s10434-006-9237-z","article-title":"Reoperative sentinel lymph node biopsy: A new frontier in the management of ipsilateral breast tumor recurrence","volume":"14","author":"Port","year":"2007","journal-title":"Ann. Surg. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"240","DOI":"10.21037\/atm-22-3702","article-title":"Axillary management of breast cancer patients with isolated chest wall recurrence after mastectomy","volume":"11","author":"Lim","year":"2023","journal-title":"Ann. Transl. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3018","DOI":"10.1245\/s10434-019-07545-y","article-title":"Management Strategies for Locally Recurrent Breast Cancer: Redo-Lumpectomy, Redo-Sentinel Node Biopsy, Redo-Radiation","volume":"26","author":"Grobmyer","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","unstructured":"(2025, August 04). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Genetic\/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate. National Comprehensive Cancer Network; version 1. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/genetics_bopp.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.breast.2022.09.004","article-title":"Suggestion for the omission of post-mastectomy chest wall radiation therapy in patients who underwent skin-sparing\/nipple-sparing mastectomy","volume":"66","author":"Kim","year":"2022","journal-title":"Breast"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.breast.2022.04.007","article-title":"Validation of a prognostic scoring system for postmastectomy locoregional recurrence in breast cancer","volume":"64","author":"Kindts","year":"2022","journal-title":"Breast"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4174\/astr.2023.104.1.1","article-title":"Prognosis according to the timing of recurrence in breast cancer","volume":"104","author":"Lee","year":"2023","journal-title":"Ann. Surg. Treat. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2813","DOI":"10.1002\/cncr.10572","article-title":"Prognostic factors for death after an isolated local recurrence in patients with early-stage breast carcinoma","volume":"94","author":"Arriagada","year":"2002","journal-title":"Cancer"},{"key":"ref_11","unstructured":"(2025, October 17). NCCN Guidelines Version 5. 2025 Invasive Breast Cancer, Treatment of Local and Regional Recurrence. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/breast.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1245\/s10434-014-4282-5","article-title":"Second Axillary Sentinel Lymph Node Biopsy for Breast Tumor Recurrence: Experience of the European Institute of Oncology","volume":"22","author":"Intra","year":"2015","journal-title":"Ann Surg Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1245\/s10434-015-5003-4","article-title":"Reoperative Sentinel Lymph Node Biopsy is Feasible for Locally Recurrent Breast Cancer, But is it Worthwhile?","volume":"23","author":"Ugras","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S1470-2045(13)70076-7","article-title":"Incidence of unilateral arm lymphoedema after breast cancer: A systematic review and meta-analysis","volume":"14","author":"DiSipio","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s10549-015-3571-4","article-title":"Repeat sentinel node biopsy should be considered in patients with locally recurrent breast cancer","volume":"153","author":"Vugts","year":"2015","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S529","DOI":"10.1245\/s10434-015-4787-6","article-title":"Improving the Success Rate of Repeat Sentinel Node Biopsy in Recurrent Breast Cancer","volume":"22","author":"Vugts","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_17","first-page":"19","article-title":"Current Strategies for the Management of Locoregional Breast Cancer Recurrence","volume":"33","author":"Wapnir","year":"2019","journal-title":"Oncology"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lim, G.H., Alcantara, V.S., Allen, J.C., Saffari, S.E., Tan, V.K.M., Tan, K.T.B., Ngaserin, S., Tan, S.M., Leong, L.C.H., and Wong, F.Y. (2024). Long-Term Oncologic Outcomes of Omitting Axillary Surgery in Breast Cancer Patients with Chest Wall Recurrence after Mastectomy. Cancers, 16.","DOI":"10.3390\/cancers16152699"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/1477-7819-8-59","article-title":"Axillary sentinel lymph node biopsy after mastectomy: A case report","volume":"8","author":"Vicente","year":"2010","journal-title":"World J. Surg. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1245\/s10434-021-10986-z","article-title":"How to Perform Repeat Sentinel Node Biopsy Safely After a Previous Mastectomy: Technical Features and Oncologic Outcomes","volume":"29","author":"Vicini","year":"2022","journal-title":"Ann. Surg. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1002\/jso.27496","article-title":"Repeat sentinel lymph node surgery for locally recurrent breast cancer after prior mastectomy","volume":"129","author":"Schulze","year":"2024","journal-title":"J. Surg. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1245\/s10434-015-4971-8","article-title":"Sentinel lymph node mapping in post-mastectomy chest wall recurrences: Influence on radiation treatment fields and outcome","volume":"23","author":"Johnson","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.jamcollsurg.2008.06.139","article-title":"Reoperative sentinel lymph node biopsy after previous mastectomy","volume":"207","author":"Karam","year":"2008","journal-title":"J. Am. Coll. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Torras, I., Cebrecos, I., Castillo, H., Rodr\u00edguez, L., Zaragoza-Ballester, P., Sitges, C., Loinaz, I., Garcia, M., Molla, M., and Vidal-Sicart, S. (2024). Surgical Management and Its Impact on Adjuvant Treatment in Recurrent Ipsilateral Breast Cancer: A Retrospective Cohort Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13175142"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1002\/bjs.11097","article-title":"Prognostic impact of repeat sentinel lymph node biopsy in patients with ipsilateral breast tumour recurrence","volume":"106","author":"Poodt","year":"2019","journal-title":"Br. J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2417","DOI":"10.1245\/s10434-019-07272-4","article-title":"Low Risk of Development of a Regional Recurrence After an Unsuccessful Repeat Sentinel Lymph Node Biopsy in Patients with Ipsilateral Breast Tumor Recurrence","volume":"26","author":"Poodt","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1245\/s10434-018-6384-y","article-title":"Risk of regional recurrence after negative repeat sentinel lymph node biopsy in patients with ipsilateral breast tumor recurrence","volume":"25","author":"Poodt","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1002\/jso.24423","article-title":"Sentinel lymph node biopsy and aberrant lymphatic drainage in recurrent breast cancer: Findings likely to change treatment decisions","volume":"114","author":"Karanlik","year":"2016","journal-title":"J. Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2526","DOI":"10.1245\/s10434-014-4338-6","article-title":"Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer","volume":"22","author":"Uth","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.ejso.2010.05.009","article-title":"Staging and management of axillary lymph nodes in patients with local recurrence in the breast or chest wall after a previous negative sentinel node procedure","volume":"36","author":"Derkx","year":"2010","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3816\/CBC.2006.n.037","article-title":"Sentinel lymph node surgery in locally recurrent breast cancer","volume":"7","author":"Boughey","year":"2006","journal-title":"Clin. Breast Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.ejso.2006.08.007","article-title":"Lymphatic mapping and sentinel node harvesting in patients with recurrent breast cancer","volume":"32","author":"Roumen","year":"2006","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s10549-018-4707-0","article-title":"Chest wall recurrence in pT1-2N0-1 breast cancer patients after mastectomy without radiotherapy","volume":"169","author":"Chang","year":"2018","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1245\/s10434-012-2625-7","article-title":"Sentinel Node and Recurrent Breast Cancer (SNARB): Results of a nationwide registration study","volume":"20","author":"Roumen","year":"2013","journal-title":"Ann. Surg. Oncol."},{"key":"ref_35","first-page":"3325","article-title":"Applicability of Oncoplastic Breast Conserving Surgery in Asian Breast Cancer Patients","volume":"17","author":"Lim","year":"2016","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jss.2009.08.014","article-title":"Predictors of axillary lymph node involvement in women with T3 breast cancers: Analysis of 1988\u20132003 SEER data","volume":"161","author":"Fields","year":"2010","journal-title":"J. Surg. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1111\/j.1445-2197.2006.03918.x","article-title":"Tumour size as a predictor of axillary node metastases in patients with breast cancer","volume":"76","author":"Laura","year":"2006","journal-title":"ANZ J. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10549-013-2409-1","article-title":"Repeat sentinel node biopsy in patients with locally recurrent breast cancer: A systematic review and meta-analysis of the literature","volume":"138","author":"Voogd","year":"2013","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1002\/bjs.10289","article-title":"Meta-analysis of aberrant lymphatic drainage in recurrent breast cancer","volume":"103","author":"Ahmed","year":"2016","journal-title":"Br. J. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1200\/JCO.2017.76.5719","article-title":"Efficacy of Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional Recurrence of Breast Cancer: Final Analysis of the CALOR Trial","volume":"36","author":"Wapnir","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1056\/NEJMoa2108873","article-title":"21-gene assay to inform chemotherapy benefit in node-positive breast cancer","volume":"385","author":"Kalinsky","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s00066-015-0939-7","article-title":"DEGRO practical guidelines for radiotherapy of breast cancer VI: Therapy of locoregional breast cancer recurrences","volume":"192","author":"Harms","year":"2016","journal-title":"Strahlenther. Onkol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1002\/jum.14998","article-title":"Ultrasound Imaging for Detecting Metastasis to Level II and III Axillary Lymph Nodes after Axillary Lymph Node Dissection for Invasive Breast Cancer","volume":"38","author":"Lin","year":"2019","journal-title":"J. Ultrasound Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.crad.2009.05.006","article-title":"CT staging of loco-regional breast cancer recurrence. A worthwhile practice?","volume":"64","author":"Tennant","year":"2009","journal-title":"Clin. Radiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/s10549-022-06654-9","article-title":"Added value of repeat sentinel lymph node biopsy in FDG-PET\/CT node-negative patients with ipsilateral breast cancer recurrence","volume":"194","author":"Haarsma","year":"2022","journal-title":"Breast Cancer Res. Treat."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T16:29:04Z","timestamp":1769617744000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/2\/273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":45,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["medicina62020273"],"URL":"https:\/\/doi.org\/10.3390\/medicina62020273","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}