Axillar chylous fistula, a rare complication after axillary lymph node dissection

Background: Chylous fistulas following axillary surgery represent a rare, but significant complication, with a limited number of reported cases in the existing literature. Therefore, there is no consensus or a clinical guideline regarding the management of this condition [1]. Case description: A 67-year-old female, with no relevant medical history, after diagnosis of breast cancer (luminal B Her2-negative invasive ductal carcinoma, cT2N2M0) underwent surgical intervention involving left breast-conserving surgery and left axillary lymph node dissection. On the fifth day postoperative, a change in the drainage color and an increase in its volume were observed. Axillary chylous fistula was then clinically suspected, so a biochemical analysis of the drainage was request. The presence of triglycerides confirmed the diagnosis. A conservative approach was adopted, incorporating a low-fat diet and medical treatment with octreotide. Resolution ensued after 13 days of treatment, facilitating the patient’s discharge on the 18th postoperative day.