Round block technique in the management of early stages of breast cancer: an assessment of the technique, oncological safety, and cosmetic outcomes

Background
The round block technique is a unique breast resection through a periareolar doughnut incision. However, it is more technically challenging and time consuming. The aim of this study was to introduce our round block technique and to evaluate the results of oncological and cosmetic outcomes.
Patients and methods
A total of 60 female patients diagnosed with early stages of breast cancer (T1–2, N0–1, ≤M0) were treated with breast-conserving surgery using the round block technique at Ain Shams University Hospitals from March 2014 to March 2017. Patients with advanced breast cancer, with tumors less than 1.5 cm from the nipple, multicentric breast cancer, and pregnant women were excluded from the study. We minimized the extent of skin removal and used the purse–string technique in doughnut closure. Patients’ related complications, oncologic safety, cosmetic outcome, and patient satisfaction were assessed.
Results
The mean size of the tumors was 2.7 cm (range: 0.9–4.5 cm). The mean distance of the tumors from the nipple was 6.25 cm (range: 1.5–11 cm) on sonogram and most of the tumors were located on the upper breast (46.6%). The median operative time was 120 min (range: 90–145 min), including axillary surgeries. The median follow-up duration was 12 months (range: 2–36 months). Up to the longest 3 years of follow-up, favorable cosmetic results have been found in patients treated with the round block technique, with no cases of local recurrence.
Conclusion
The round block technique is oncologically safe and feasible for early stages of breast cancer, with favorable cosmetic results.