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An isolated late chest wall recurrence after mastectomy for breast cancer is rare. We present a case of a lady with a T2N1M0 right breast cancer who developed an isolated local recurrence on the chest wall 11 years after mastectomy. Staging investigations excluded distant metastases. She underwent an excisional biopsy and was started on an aromatase inhibitor. Radiotherapy was given to the chest wall followed by a boost to the site of excision. Although most chest wall recurrences fare poorly, a favourable subgroup can be identified and should be treated aggressively in a multidisciplinary approach.
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