Round Block Technique of Breast-Conserving Surgery—Our Experience from a Tertiary Care Center in India

Surgery remains the cornerstone in management of breast lumps. Breast conservation surgery (BCS) entails removal of disease with negative histopathological margins and satisfactory cosmesis. The adoption of mammoplasty techniques amongst surgeons have enabled them to improve the number of patients deemed suitable for BCS without having obvious breast asymmetry and unsightly scars. We herein describe our experience with round block technique (RBT). This is retrospective analysis of prospectively collected data of patients with carcinoma breast and benign fibro-epithelial lesions (fibroadenoma and benign phyllodes) operated by RBT from September 2016 to January 2020. Patients with lesions in retroareolar, peri-areolar region, and close to skin were excluded. The study evaluated adequacy of surgical resection as assessed by negative margins on histopathology and post-operative cosmesis. Post-operative cosmesis was assessed on a Likert scale (incorporating breast ptosis and symmetry) by patient and doctor independently at 1 month post-surgery. During the study period, 20 patients (15 patients carcinoma breast and 5 benign fibroepithelial lesion) underwent BCS by RBT. All 20 patients achieved adequate resection with negative margins on histopathology. Patient-reported outcomes for cosmesis were excellent 4 patients, good 15 patients, fair none, and poor 1 patient. The same as done by doctor was excellent in 4 patients, good in 14, and fair and poor in 1 each. Correlation coefficient between outcomes rated by the patient and doctors was 0.945. No nipple-areola necrosis was seen. Round block technique is safe and versatile option for patients wanting BCS with good post-operative cosmetic outcome with satisfactory oncological outcome.