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

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.