Work

Chylorrhea After Breast-Conserving Surgery: A Case Report with Literature Review

Year: 2026

Type: article

Abstract: Background Chylorrhea is an exceptionally rare complication after breast-conserving surgery with limited axillary sampling. This report presents a case of an early postoperative chyle leak after breast-conserving surgery and contextualizes its presentation, diagnosis, and management through a focused literature review. Case Presentation A 52-year-old woman with grade III triple-negative invasive ductal carcinoma of the left breast declined neoadjuvant chemotherapy and underwent wide local excision with axillary lymph node sampling. Approximately 10 hours postoperatively, the axillary drain produced blood-stained milky fluid. Drain-fluid analysis showed triglycerides of 641 mg/dL and cholesterol of 74.8 mg/dL, supporting the diagnosis of chylous leakage. Chest radiography showed no pleural effusion. Conservative management comprised closed-suction drainage, a fat-free diet, and subcutaneous octreotide (100 μg three times daily for 2 days). The patient left the hospital against medical advice on postoperative day 2 and returned on day 12 for suture removal and oncology referral; leak resolution was not documented. Literature Review A focused literature search identified 13 previously reported patients. Twelve (92.3%) had left-sided surgery, and four (30.8%) developed leakage after sentinel lymph node biopsy or limited axillary sampling. When documented, leakage appeared on postoperative days 1–10. Eight patients (61.5%) recovered with conservative treatment, and five (38.5%) required surgical ligation or mass closure. Conclusion Chylous leakage should be considered when milky axillary drainage develops after breast-conserving surgery, even after limited nodal sampling. Early recognition may facilitate prompt conservative management and reduce the need for surgical intervention.

Source: Surgery Case Reports

DOI: 10.1016/j.sycrs.2026.100236