A challenging case of a chyle leak following axillary lymph node clearance

Chyle leak following axillary lymph node clearance is a rarely reported complication. We present a case of chylous leakage following axillary lymph node clearance, which was diagnosed on clinical grounds. Surgical re-exploration was undertaken due to ongoing high output. However, the chylous leak recurred post-operatively, if at a lower rate. The patient was subsequently managed successfully with conservative measures, primarily utilizing regular aspiration and compression bandaging to the axilla.

ADEQUACY OF AXILLARY LYMPH NODE CLEARANCE IN BREAST CARCINOMA: ARE WE ACHIEVING THE RECOMMENDED STANDARDS?

Introduction: In the setup of breast cancer management, axillary lymph node clearance plays a role in staging and planning of adjuvant chemotherapy and local control of cancer. Harvesting minimum of 10 lymph nodes for histopathological analysis is cut off value to consider a 90% certainty of a true negative axillary lymph node after axillary clearance. Aim: To assess the adequacy of axillary lymph node clearance considering influence of tumor factor (size, site, grade, type, lymphovascular invasion and hormonal and HER 2-NEU receptor status). Method: Retrospective analysis of histopathological report included 117 patients underwent mastectomy and axillary lymph node clearance from January 2011 to July 2016 in professorial surgical unit teaching hospital Jaffna. The analysis assessed the adequacy of the axillary lymph node clearance considering the influence of tumor factor. Results: Adequate axillary lymph node clearance was done in 89.7% (105). None of considered factors showed significance influence (p<0.05) except tumor type. Conclusion: Unit achieved desirable adequacy in axillary lymph node clearance, clearance adequacy is not associated with considered tumor factors except tumor type. Keywords: Axillary lymphnode clearance, Adequacy, Breast cancer, nodal status