Abstract
Introduction: Breast carcinoma is one of the common causes of cancer related deaths in women and along with colorectal and lung cancers is responsible for approximately 40% of cancer related deaths in women. The single most important prognostic factor in determining the outcome of treatment in these patients is the stage in which it is detected. The early detection of carcinoma breast is associated with excellent prognostic outcome. Triple test consisting of physical examination; mammogram and fine needle aspiration cytology is one of the most sensitive test for early detection of carcinoma breast and is found to have a considerably high sensitivity in detection of carcinoma breast as compared to any single test such as mammography or fine needle aspiration cytology. The modified triple test which substitutes mammography by ultrasound examination is also found to be highly sensitive in early detection of breast carcinoma we conducted this study to assess the accuracy of modified triple test score i.e. clinical examination, ultrasonography and fine needle aspiration cytology in breast lump by comparing with histopathology.
Materials and Methods: 50 women with palpable breast lump attending surgical outpatient and inpatient who underwent surgery for the same were included in the study on the basis of a predefined inclusion and exclusion criteria. Clinical examination of all the patients in respect to size of breast lump, site, consistency, tenderness, mobility and fixity to underlying structures was assessed in all the cases. Ultrasonography of both breast and axillae and Fine needle aspiration cytology of breast lump was done in all the cases. The accuracy of modified triple test was assessed by comparing the histopathology of the breast lump. SSPE 16.0 software was used for statistical analysis and p value less than ‘0.05’ was taken as statistically significant.
Results: Out of 50 studied cases 15 turned out to be malignant on histopathology, 14 patients had intra ductal carcinoma (no special type) and 1 had mucinous carcinoma. 35 were benign lesions on histopathology, 26 had fibro adenoma, 5 had fibrocystic disease and 2 had mammary hamartoma. Out of 50 patients, 34 had MTTS score of 3 or 4 points all of which were proved benign on histopathology report.15 patients had MTTS score of 6 and above and all were malignant on HPR, out of which 14 were intraductal carcinoma. Only 1 patient had a score of 5 and it was proved to be benign.
Conclusion: Modified triple test score assessment is highly sensitive and specific in diagnosing breast lumps as well as differentiating benign from malignant breast pathologies.
Keywords: Modified Triple Test, Clinical Examination, Fine Needle Aspiration Cytology, Ultrasonography.
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Corresponding Author
Dr P.D. Gurav
Professor and Head of the Department, Department of General Surgery Government Medical College
Miraj- Maharashtra (India)
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.178
