AIM: To investigate the long-term prognosis of patients with axillary recurrence after axillary dissection for invasive breast cancer and describe the long-term survivors. METHODS: Between 1984 and 1994, 4669 patients with invasive breast cancer underwent axillary dissection in eight community hospitals in the south-eastern part of The Netherlands. Using follow-up data of the population-based Eindhoven Cancer Registry, 59 patients with axillary recurrence were identified. RESULTS: The median interval between treatment of the primary tumour and diagnosis of axillary recurrence was 2.6 years (range 0.3-10.7). The median length of follow-up after diagnosis of axillary recurrence was 11.1 years (5.7-15.6). Distant metastases occurred in 38 of the 59 patients. The 5- and 10-year distant recurrence-free survival rates were 39% (95% CI: 25-52%) and 29% (95% CI: 16-42%). CONCLUSIONS: Axillary recurrence following axillary dissection is associated with a high rate of subsequent distant metastasis and poor overall prognosis but is not always a fatal event. Our results show that it is possible to cure about one-third of the patients.