Inclusion Criteria:  Patients who will undergo ALND in the treatment of breast cancer:  cT4a, cT4c and cT4d. cT4b with extensive involvement of the skin.  cN0 with SLNB positive (pN+) that need to associate ALND:  cT3-T4b. >2 lymph node macrometastasis if cTis, cT1 and cT2. Patients who underwent mastectomy and it is not possible associate adjuvant radiotherapy.  cN1:  If primary surgery treatment. After neoadjuvant systemic treatment, if there is not a clinical-radiological complete response and/or SLNB positive (ypN+).  cN2:  If primary surgery treatment. After neoadjuvant systemic treatment, if luminal tumours or there is not a clinical-radiological complete response in triple negative or HER2 overexpressed tumours. cN3.  Exclusion Criteria:  Patients with previous axillary surgery (except sentinel node biopsy) Patients who did previous axillary radiotherapy treatment. Patients who do not wish to participate in the study.