The aim of the study is to compare between active drainage and passive drainage in post-operative seroma formation after modified radical mastectomy in female patient with breast carcinoma as regard of:

Primary Outcomes:

1. Daily drain output (measured in mL/day).
2. Duration of the drain in place.
3. Amount of seroma aspiration after the drain removal.
4. Number of days till the last seroma aspiration.

Secondary Outcomes:

1. Flap necrosis.

2. Surgical site infection. 100 female divided into two equal groups:

   • Group A: Active drainage group (50 patients).
   • Group B: Passive drainage group (50 patients). After MRM ,drain output was measured daily using a graduated jar by nurse during hospital stay which was a one to two days in an average and then by patient himself. All the data was recorded on a paper sheet. In passive drain, breast and axilla outcomes were combined together as one read to be equal to one active drain gar. Twice per week, I checked this reading by myself and reported any complications).

Inclusion Criteria:

• Female patient diagnosed with breast carcinoma planned for MRM

Exclusion Criteria:

• • Previous breast surgery.

  • Active infection.
  • Recurrent or metastatic breast cancer (Stage IV).
  • Un-controlled diabetes mellitus (HbA1C >7).
  • Coagulopathy disease.
  • Use of anticoagulant or antiplatelet medications.
  • Bilateral breast cancer.
  • Loss to follow-up within one month of drain removal.
  • Pregnancy.
  • Male breast cancer patients.

only female with breast cancer was enrolled