Surgical treatment of the axilla in breast cancer patients is a controversial issue, as not only staging must be ensured, but also regional disease control. Twenty seven histologically verified axillary recurrences encountered over a period of 20 years were analysed according to primary tumours and their axillary metastases. The median age of the 27 investigated patients was 57 years. Axillary recurrences occurred in 7 node negative patients (26%), 10 (37%) and 6 (22%) patients with 1-3 and more than 3 positive nodes, respectively. The number of histologically assessed lymph nodes was less than 6 in more than one third of the patients. No axillary status was available in 4 cases. Extracapsular axillary tumour spread seemed high (63%) in the recurrent group. Axillary recurrences may sometimes occur even after adequate surgical and radiotherapeutical interventions, and axillary nodal status established on the basis of low lymph node numbers and extracapsular tumour spread may predispose to this. Such features must be considered when planning adjuvant treatment options.