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 accuracy 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.
Highlights
One-fourth of women suffer from breast disease in their life time.[1,2] Carcinoma of breast is the second most common cancer in the world.[3]
There are various modalities for the diagnosis of a breast lump such as mammography, ultrasonography, fine needle aspiration cytology but none of them are without impunity
We evaluated the efficacy of TSS in correctly predicting the nature of a breast lump by comparing it with the histopathological diagnosis so that we can safely subject our patients to management based on it
Summary
One-fourth of women suffer from breast disease in their life time.[1,2] Carcinoma of breast is the second most common cancer in the world.[3] With the improvement in health care and increasing longitivity, more and more females are being exposed to the risk of developing breast carcinoma. Lump in the breast has been viewed with scepticism resulting in delay in seeking treatment. And accurate diagnosis of a breast lump with early intervention can be lifesaving. Delay can lead to deprivement of curative treatment where as aggressive management can expose the patient to unwarrented surgeries and psychological and social traumas to the patient and the risk of litigtion to the surgeon
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