A Case Series of Round Block Techniques for Large, Recurrent, and Multicentric Benign Breast Diseases

Abstract

Benign breast diseases are a common presentation in the breast clinic outpatient department. These diseases, including giant fibroadenoma, multiple fibroadenoma in different quadrants, and large or recurrent phyllodes tumors, pose challenges in surgical management. We present a case series of 16 patients aged 19 to 63 years (average age, 41.5 years) who presented with breast lumps and underwent surgery using the round block technique for benign breast diseases at our institute between November 2019 and March 2024. Prior to surgery, all patients had clinical, radiological, and pathological assessments. Age, duration of lump, and detailed menstrual, obstetric, and family history of each patient were recorded. Eight (50%) of the patients had phyllodes tumor, four (31.25%) had fibroadenoma, three (18.75%) had both fibroadenoma and phyllodes tumor, and one (6.25%) had adenolipoma. The average size of tumors was 7.5 cm in our study. During postsurgical follow-up, none of the patients had nipple areola necrosis, and they reported that nipple sensation was acceptable. A mastectomy was avoided in all circumstances. Good cosmetic outcomes and clear margin status are achievable using the round block technique.

Keywords: benign breast lesions; giant fibroadenoma; multicentric fibroadenoma; phyllodes; recurrent phyllodes.

Figure 1. Left breast juvenile fibroadenoma.

(a) Preoperative image with tumor outlined in dotted lines, (b) intraoperative incision, (c) cavity after excision, (d) tumor after excision, and (e) 1-week postoperative image.

Figure 2. Giant fibroadenoma.

(a) Preoperative image, (b) intraoperative circular incision, (c) cavity after excision, (d) tumor after excision, (e) 1-week postoperative image, and (f) 1-month postoperative image.

Figure 3. Multicentric fibroadenoma.

(a) Preoperative image, (b) intraoperative markings, (c) circular incisions, (d) tumor post-excision, (e) postoperative image (1 week later), and (f) postoperative image (3 months later).

Figure 4. Left breast recurrent phyllodes tumor.

(a) Preoperative image in anterior view, (b) preoperative image in lateral view (note the previous radial scar), (c) intraoperative circular incision, (d) tumor with margins marked with silk, (e) postoperative image (anterior view) after 3 months, and (f) postoperative image (lateral view) after 3 months.

Figure 5. Adenolipoma of left breast.

(a) Tumor with margins marked with silk, (b) intraoperative circular incisions, (c) cavity after tumor removal, (d) 1-week postoperative image, and (e) 3-months postoperative.