A 41-year-old woman had a palpable mass in the upper inner quadrant of her left breast. Radiological workup and biopsy showed an invasive ductal carcinoma with triple-negative features which was 3.7 cm in size. After 6 months of neo-adjuvant chemotherapy, the tumor achieved clinical complete response; then, breast-conserving surgery became possible. She had small-sized breasts without ptosis, and the original tumor location was 5 cm away from the nipple. Thus, we decided to perform a modified round block technique (MRBT) (Zaha et al. 2013). This technique permits distant tumor excision without excision of the periareolar skin and also gives the surgeon the opportunity to use adequate adjacent breast tissue to fill the breast defect even in a small-sized breast.