A tissue-saving strategy for removing giant breast fibroadenoma using the modified Swiss roll method: theoretical foundations – a case report

Pooja Bajaj; Aninda Mandal; Nilay Kumar; Abhishek Khalkho; Shrawan Kumar

doi:10.18203/2349-2902.isj20263869

Authors

Pooja Bajaj Department of General Surgery, Bokaro General Hospital, Jharkhand, India
Aninda Mandal Department of Plastic Surgery, Bokaro General Hospital, Jharkhand, India
Nilay Kumar Department of General Surgery, Bokaro General Hospital, Jharkhand, India
Abhishek Khalkho Department of Plastic Surgery, Bokaro General Hospital, Jharkhand, India
Shrawan Kumar Department of General Surgery, Bokaro General Hospital, Jharkhand, India

DOI:

https://doi.org/10.18203/2349-2902.isj20263869

Keywords:

Breast surgery, Minimally invasive extraction, Modified Swiss-roll method, Giant fibroadenoma

Abstract

It may be difficult to remove giant fibroadenomas (5 cm or more) using conventional techniques. Large lesions can distort breast shape, and in young women the cosmetic effect of the incision and the preservation of breast contour are important considerations. The Modified Swiss-roll procedure allows removal of a large, mobile, encapsulated tumour through a relatively small circumareolar incision while minimizing manipulation of the surrounding breast tissue. This case describes a 19 year old woman with a rapidly enlarging right breast mass diagnosed as a giant fibroadenoma. The tumour was carefully mobilized and delivered through a small circumareolar incision using a modified Swiss-roll manoeuvre, with initial fixation using 2-0 Vicryl sutures and minimal tissue handling.

References

Hughes LE, Mansel RE, Webster DJT. Aberrations of normal development and involution (ANDI): a new perspective on pathogenesis and nomenclature of benign breast disorders. Lancet. 1987;2:1316-9.

Greenberg R, Skornick Y, Kaplan O. Management of breast fibroadenomas. J Gen Intern Med. 1998;13(9):640-5.

Neinstein LS. Breast disease in adolescents and young women. Pediatr Clin North Am. 1999;46(3):607-29.

Naraynsingh V, Maharaj D, Rampaul R. "Swiss-roll" operation for giant fibroadenomas. Breast J. 2002;8(1):45-6.

Kuijper A, Mommers ECM, van der Wall E, van Diest PJ. Histopathology of fibroadenoma of the breast. Am J Clin Pathol. 2001;115(5):736-42.

Soomro SA, Memon SA, Mohammad N, Maher M. Swiss roll operation for giant fibroadenoma. J Ayub Med Coll Abbottabad. 2009;21(1):76-8.

Kulkarni SB, Naveen S, Hanumanthaiah KS. Swiss roll method of fibroadenoma excision: a case series. Int Surg J. 2023;10(7):1204-6.

Cheng PJ, Vu LT, Cass DL, Hicks MJ, Brandt ML, Kim ES. Endoscopic specimen pouch technique for removal of giant fibroadenomas of the breast. J Pediatr Surg. 2012;47(4):803-7.

Naraynsingh V, Pran L, Islam S, Cawich S. The "Saw Tooth" operation for giant fibroadenomas. Int J Surg Case Rep. 2017;41:304-6.