Appropriate timing for breast reconstruction.

Once a chest-wall recurrence is diagnosed, it should be treated by modalities effective for both local and systemic disease, since it is a cutaneous marker of distant metastases. If the chest-wall recurrence can be controlled, short-term prognosis is much improved, although all patients in this study eventually died of systemic breast cancer. The results of this retrospective study suggest that appropriate timing of breast reconstruction depends on the pathologic status of the axillary nodes and completion of adjunctive therapy. A patient with stage I breast cancer can undergo a subpectoral or musculocutaneous flap reconstruction of the breast without fear of masking a local chest-wall recurrence.