Round block technique without cerclage in breast-conserving surgery

Background: Round block technique is a unique breast resection through periareolar doughnut incision. However, it is more technically challenging and time consuming. We simplified the procedure by exclusion of round block cerclage. The purpose of this study was to introduce our round block technique without cerclage and to evaluate the results of oncological and cosmetic outcomes. Methods: A total of 92 patients with centrally located breast cancer were treated with breast-conserving surgery using round block technique at Samsung Medical Center from July 2009 to May 2012. All patients had a small breast defect with excised breast volume less than 20 % compared to the total breast volume. We minimized the extent of skin removal and used simple interrupted inverted intradermal sutures without cerclage in doughnut closure. Patient's cosmetic satisfaction was assessed by subjective questionnaires at least 6 months after the operation. Results: The median size of tumors was 1.7 cm (range 0.5-5.0 cm). The average distance of the tumors from the nipple was 2.0 cm (range 0.0-4.0 cm) on sonogram and most of the tumors were located upper breast (82.6 %). The median operative time was 101.5 min (range 55-180), including axillary surgeries. Median follow-up was 12.0 months (range 2-36), and none of patients have developed local recurrence. Up to the longest 3 years of follow-up, favorable cosmetic results have been found in patients treated with round block technique. Conclusions: Round block without cerclage is technically easy and feasible for centrally located breast tumors with favorable cosmetic results.