Single center experience of Round Block technique for breast surgery; Oncologic safety and patient satisfaction

Abstract

Round block technique is a versatile technique for the excision of benign and malignant lesions with oncologic safety. It is a technically challenging procedure as compared to other oncoplastic procedure. It has the benefit of an inconspicuous scar and gives desirable aesthetic outcomes and also provides wider exposure for tissue resection and remodelling. This study discusses the utility of RBT for the excision of different pathologies, complications, and cosmetic outcomes.

METHODS AND MATERIALS: The study was conducted at the breast surgery clinic, at Liaquat national hospital. All patients undergoing the round block technique as per clinical indications were included. The clinical size, site, distance from the nipple, pathology, pathological size, and margin status were recorded. Early and late complications were documented during the follow-up. At the time of the final study analysis, patients were interviewed for cosmetic outcome satisfaction using the Harvard scale (4-point Likert score)

RESULTS: 49 patients were included in the study over 2.5 years. The mean clinical tumor size was 4.72cm, 63% were in the upper quadrant, and the average distance from the areolar margin was 1.71cm. The pathology included 21 fibroadenomas and 18 carcinomas, mean size 4.14cm. Early complications in 12 cases, and late complications in 2 cases were seen and all were managed conservatively. The cosmetic outcome was reported as fair 6.1%, 87% good and 6.1% excellent

CONCLUSION: RBT is robust and although technically challenging is easily adaptable. It provides good exposure for excision of both benign and malignant tumors of the breast with the oncologic safety margin. The peri-areolar or peripheral lesions especially in the upper inner quadrant excision can be performed with a well-concealed scar and desirable aesthetic results.