Background Breast cancer is the most common cancer in women all over the world representing 18% of all women reported cases of cancer. It represents the leading cause of women mortality as representing 23% of all women cancer deaths. The decision in any breast cancer patient is taken by MDT that includes breast surgery consultant, pathology consultant, plastic surgery consultant, radiology consultant and medical oncology consultant. Breast conserving surgeries are now the standard technique for management of breast cancer patient. Oncoplastic techniques are replacing SWLE for their better cosmetic outcomes and better exposure of the tumor. Objective The aim of this work was to assess the round block technique as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision. Methods This is a retrospective study to assess the round block technique as an oncological procedure for management of early breast cancer near to nipple-areola complex as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision. It was conducted at general surgery department, Ain Shams university hospitals. Approval of the Ethical Committee and written informed consent from all participants were obtained. In our study 40 breast cancer patients are subdivided into group (A) 20 females which underwent round block technique and group (B) 20 femaleswhich underwent standard wide local excision. Patient and tumor criteria including age, co morbidities, tumor size and distance between tumor and nipple-areola complex were considered to be nonsignificant between 2 groups so the only difference is the surgical technique. Results The study shows that the round block technique and SWLE have the same results regarding hospital stay, post operative complications and oncological recurrence with the advantage to RBT because of its better cosmetic outcomes. So, the round block technique is superior to SWLE in selected cases. Conclusion The round block technique has comparable post operative parameters with better cosmoses as it is scarless operation without nipple and areola shift suggesting that the round block technique is superior to SWLE in selected cases.