Diagnostic ultrasound of the chest wall in the symptomatic patient after mastectomy

•After mastectomy, 93.1% of recurrences manifest as a palpable lump or a skin change, while pain only is a rare manifestation (1.7% of recurrences).•Ultrasound evaluation of the chest wall in symptomatic patients after mastectomy yields 91.4% sensitivity and 99.3% negative predictive value for cancer detection, however the cancers detected are moderate in size with a median size of 20 mm.•All false negative ultrasound cases manifestred with suspicious skin changes.