Jeffrey et al1 reported a 42% need for axillary seroma aspiration when axillary drainage was omitted in patients having axillary dissection as part of their breast conservation treatment for breast cancer. Admittedly this complication is not extremely serious but is certainly uncomfortable and inconvenient. The choice need not be exclusively between closed suction drainage and no drainage at all.
In my own series2 of 133 same-day surgery patients having partial mastectomy and limited axillary dissection, the incidence of clinical seroma was 2.3%. All patients had drainage of the axilla with a single ¼-inch Penrose drain incorporated into a bulky fluff pressure dressing. The drain was removed at an office visit 48 to 72 hours postoperatively and a previously placed untied 5-0 nylon suture was tied at the axillary drain site. Arm exercises were started at 17 to 20 days postoperatively.
A ¼-inch Penrose drain used as described above
Seltzer MH. Axillary Lymphadenectomy for Breast Cancer Without Axillary Drainage. Arch Surg. 1996;131(6):677. doi:10.1001/archsurg.1996.01430180103026