Breast cancer is the most common malignancy worldwide and a leading cause of cancer related death among women. Modified Radical Mastectomy remains a cornerstone of surgical management, but postoperative complications such as seroma formation remain a significant concern. Seroma, the most frequent complication following mastectomy, occurs in 3 to 85 percent of cases and can result in flap necrosis, infection, and wound dehiscence. The use of closed suction drains is a common strategy to reduce seroma formation, but there is ongoing debate regarding the optimal number of drains.

The study will be conducted at the Department of General Surgery, All India Institute of Medical Sciences, Gorakhpur Uttar Pradesh India. This tertiary care centre is equipped with advanced medical facilities and a high volume of surgical cases, providing a suitable environment for conducting a randomized controlled trial. The setting ensures access to a diverse patient population undergoing Modified Radical Mastectomy, allowing for robust data collection and analysis. This study is a prospective, randomized, controlled, single blinded, parallel assignment, single centre trial designed to compare post operative outcomes of single drain versus double drain placement in patients undergoing Modified Radical Mastectomy. A patient who will fulfil the inclusion criteria and does not satisfy any of the exclusion criteria will be randomized into two groups. Group A (Single Drain Group)  single drain will be placed beneath the mastectomy flap and coming out through axilla. Group B (Double Drain Group) Two drains will be placed one in the axilla and the other beneath the mastectomy flap. All patients will have a 16 French  negative suction drain placed intraoperatively. The drain output will be measured and recorded daily. Drains will be removed once the daily output falls below 10 ml. All patients will receive the same postoperative care, including antibiotics and other medications, to minimize treatment variability. Statistical analysis will be performed to assess differences in outcomes between the two groups. The study evaluates outcomes including incidence of seroma, Pain, Flap necrosis, Wound Gaping and Lymphedema will be accessed in post operative period on Day 1, Day 3, Day 7, Day 10, day 15 and Day 30. The results of this study will provide evidence to Rationalize the use of Single Drain or Double drain and guide best practices, improve patient outcomes, and optimize healthcare resource utilization in Modified Radical Mastectomy.