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Background The goal of optimizing the cosmetic and oncologic outcomes of BCS has been addressed in recent years by the emergence of the field of oncoplastic surgery, that originally defined as an assortment of volume replacement techniques performed by plastic surgeons to replace all or part of the resected breast volume with myocutaneous tissue flaps. The definition of oncoplastic surgery has more recently been expanded to include a wide range of volume displacement or volume redistribution procedures performed by breast surgeons and general surgeons to optimize breast shape and breast volume following breast cancer surgery. Aim of the Work To assess the round block technique as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision. Patients and Methods This is a prospective randomized 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. Twenty breast cancer patients are subdivided into group (A) 10 females which underwent round block technique and group (B) 10 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 non-significant between 2 groups so the only difference is the surgical technique. Results The round block technique and SWLE have the same results regarding operative time, intra-operative blood loss and post operative complications with the advantage to RBT because of its better cosmetic outcomes and lower re-excision rates. So, the round block technique is superior to SWLE in selected cases. Conclusion The round block technique has comparable operative parameters to SWLE with no evidence of increased surgical complications. With a lower re-excision rates and better cosmoses were observed in the round block patients as it is scarless operation without nipple and areola shift suggesting that the round block technique is superior to SWLE in selected cases.