From 1985 to 2002, 22 patients with local recurrence after radical mastectomy have been treated in our hospital. Resection was possible in 9 patients. We evaluated long-term prognosis of the 9 patients. The observation interval from first recurrence was 17-207 months (median 91.5 months). Five of the 9 experienced recurrence again. Opposite axillary lymph node metastasis was observed in 2, bone metastasis in 1, liver metastasis in 1, and lung metastasis in 1. Disease free interval (DFI) until the first recurrence of patients with a second recurrence was 69-100 months (median 90 months). The interval from first recurrence to second recurrence was 46-108 months (median 60 months). Each second recurrence occurred within double the DFI until the first recurrence. For all of the patients in which a second recurrence was not observed, the observed interval was shorter than the DFI until first recurrence. Local recurrence should be considered systemic disease. Many of the patients who underwent resection of the local recurrence experienced a second recurrence after longer observation. We believe that patients with local recurrence should be observed for a period of about double the DFI.