Triple Assessment of Breast – Gold Standard in Mass Screening for Breast Cancer Diagnosis

Abstract

Background: In Breast cancer there is paradigm shift towards its prevention and early detection. Self breast examination and clinical breast examination plays an important role in early detection. Currently a combination of three tests, i.e. clinical examination, radiological imaging (mammography, ultrasonography) and pathology called as triple assessment test is used as Gold standard in diagnosing all palpable breast lumps. Together they give sensitivity of 99%. The triple assessment is taken as positive if any of the three components is positive and negative only if all of its components are negative for malignancy. Materials And Methods This study was conducted in the Department of Surgery, Rama Medical College Kanpur over a period of 4 years from March 2009 to Feb.2013. A total of 400 patients with a breast lump were selected irrespective of age. A detailed history, thorough clinical examination, radiological imaging and fine- needle aspiration cytology (FNAC) were used as diagnostic tools for screening of the patients. The aim of this study was to evaluate accuracy of triple assessment in the early detection of breast carcinoma. Results The sensitivity and specificity of all the modalities used in triple assessment when combined together was100% and 99.3%, respectively. The concordance for the triple assessment was 99.3%, positive predictive value was 93.3%, negative predictive value was 100%, sensitivity was100% and specificity was 99.3%. p value was significant (0.000). Conclusion Triple assessment is a very useful diagnostic tool to evaluate patients with breast lumps and to detect patients with breast cancers with an overall accuracy of 99.3%.