Central round block repair of large breast resection defects: oncologic and aesthetic outcomes

Background: The central round block repair is a volume displacement technique to reconstruct large wide local excision (WLE) defects in breasts with moderate ptosis or hypertrophy. There are limited published data on the outcomes of this technique. Methods: Data were collected prospectively for 57 consecutive patients and follow up information obtained from patient records. The volume of breast resection was estimated geometrically from mammography. Aesthetic outcomes were assessed from clinical measurements and panel review of patient photographs. Results: The median age was 51 [22–86] years and follow-up 5 (1.9–8.4) years. The median specimen resection weight was 50 [25–361] g and tumour size 25 [10–75] mm. Estimated volume of breast excised was 17.8% (6–31%). In total, 12/57 patients had incomplete margins: five patients had re-excision to achieve clear margins and seven required mastectomy. Two patients had local recurrence during the follow-up period, five developed distant metastases. Aesthetic data were completed for 35/50 patients. Twelve (34%) had no measurable asymmetry and 31 (89%) had a nipple position within 2 cm of the original height. Only two patients requested symmetrising surgery. Conclusions: Central round block reconstruction of large defects after WLE is a safe technique with good aesthetic outcomes. Contralateral symmetrising surgery is not usually required.