Accuracy of Triple Test Score in The Diagnosis of Palpable Breast Lump

Abstract

Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosis
helps to lessen the associated anxiety and leads to early definitive treatment. The aim of this study
was to evaluate the acuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpable
breast lump. This diagnostic test study was carried out in the Department of Surgery of Tribhuvan
University Teaching Hospital. Of the 117 patients admitted with breast diseases from the breast
clinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physical
examination, mammography and fine needle aspiration cytology) and were categorized into benign,
suspicious and malignant. This was later correlated with the histopathological findings. Nineteen
patients with breast lumps interpreted by TTS as benign correlated with the histopathological
findings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This gives
TTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive value
of 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age at
diagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS is
an accurate and least invasive diagnostic test based on which definitive treatment can be initiated.

Key words : breast lump, carcinoma breast, triple test score