Alexandria Main University Hospital, Alexandria, Egypt.
Surgical Oncology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Breast J. 2020 Mar;26(3):414-419. doi: 10.1111/tbj.13485. Epub 2019 Aug 25.
Round block technique (RBT) is an oncoplastic technique used in periareolar lesions, particularly in breasts with moderate ptosis or hypertrophy. However, it has some drawbacks including the possibility of late-onset scar widening, change in areolar shape, and asymmetry of the breasts. Moreover, it is hard to be performed with tumors located in periphery of breast. Modified round block technique (MRBT) is a new technique described to overcome these problems. A circumferential periareolar incision was made around the areola followed by subcutaneous dissection to the entire breast. Wide local excision (WLE) could then easily be performed with a good field of view, the breast tumor was excised with an acceptable macroscopic safety margin, and specimens were marked with orienting sutures for intraoperative frozen section. Remodeling of the breast was done, a close suction drain was placed, and the wound was narrowed with a nonabsorbable purse-string suture and attached to the NAC with continuous subcuticular absorbable suture. This study was conducted on 144 female patients diagnosed with breast cancer. The median size of the tumor was 2 cm, the majority of the patients (66.7%) had moderate breast size (cup B) and the median distance of the tumor from NAC was 7 cm. Patients' satisfaction was assessed according to Harvard scale and good to excellent results were found in 88.8% of the patients. There were no postoperative changes in areolar shape or position. Complications in the form of hematoma, wound dehiscence, and infection were encountered in 25% of the patients. Modified round block technique is an oncoplastic technique that permits excision of peripherally located breast cancer without excision of periareolar skin and it is suitable for all quadrant tumors. It also avoids the scar which occurs after ordinary breast-conserving surgery.
圆形皮瓣技术（RBT）是一种用于乳晕周围病变的整形技术，尤其适用于中度下垂或肥大的乳房。然而，它也存在一些缺点，包括迟发性瘢痕增宽、乳晕形状改变和乳房不对称等问题。此外，对于位于乳房外周的肿瘤，该技术的操作难度较大。改良圆形皮瓣技术（MRBT）是一种新的技术，旨在克服这些问题。在乳晕周围做一个环形切口，然后进行皮下剥离至整个乳房。这样就可以在良好的视野下进行广泛局部切除（WLE），乳房肿瘤可以切除并获得可接受的宏观安全切缘，标本用定向缝线标记以便术中进行冰冻切片检查。然后进行乳房重塑，放置负压引流管，并使用不可吸收的荷包缝线将切口缩小，用可吸收的皮下连续缝线将其固定到乳头乳晕复合体上。本研究纳入了 144 名被诊断为乳腺癌的女性患者。肿瘤的中位大小为 2cm，大多数患者（66.7%）乳房大小为中度（B 罩杯），肿瘤距乳头乳晕复合体的中位距离为 7cm。根据哈佛评分评估患者的满意度，发现 88.8%的患者满意度为良好至优秀。术后乳晕形状或位置无变化。25%的患者出现血肿、伤口裂开和感染等并发症。改良圆形皮瓣技术是一种整形技术，允许在不切除乳晕皮肤的情况下切除乳房外周的乳腺癌，适用于所有象限的肿瘤。它还可以避免普通保乳手术后出现的瘢痕。
