Inclusion Criteria:  Aged 18 or above. Known cases of invasive breast Cancer. Undergoing Axillary Lymph Node Dissection (ALND) alone, ALND with mastectomy or ALND with breast conservation surgery (BCS) Capacity to give informed consent  Exclusion Criteria:  Chronic diseases limiting motion of shoulder such as neuropathies, history of trauma and autoimmune diseases. Patients undergoing redo axillary lymph node dissection. Patients undergoing bilateral axillary lymph node dissection. History of chronic pain lasting more than 3 months. Potential causes include: arthritis, backache, fibromyalgia, Irritable bowel disease, irritable bowel syndrome and different types of headache. M1 stage of the TNM staging system at the time of initial diagnosis.