The local recurrence of breast cancer is a significant issue, not only to treating physician but also to the patient with breast cancer. Delayed recurrences up to 40-years may be seen, and the therapy of local recurrences is a treatment challenge. A 69-year-old woman who underwent mastectomy for breast carcinoma presented with a lump at the left chest. Her fine needle aspiration biopsy revealed invasive ductal adenocarcinoma. Local recurrence was excised including the lesion and partial pectoralis major with overlying and surrounding skin. The pathology of excised specimen revealed invasive ductal adenocarcinoma with negative margins. Radiotherapy and chemotherapy were planned. Delayed recurrence after mastectomy for breast carcinoma is a rare event. If disease-free intervals from initial mastectomy are longer prognosis of patients is better.