Evaluation of triple test score in palpable breast lump

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Evaluation of triple test score in palpable breast lump

Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 4

Abstract

Abstract: The Objective is to perform and evaluate Triple Test Score (TTS) in patients with palpable breast lump in comparison with gold standard histopathology (HPE) and to develop a standard protocol for management of breast lump especially when discordant results are obtained from triple assessment. The Study was conducted on 100 patients presenting with breast lump to the department of General Surgery at R.L. Jalappa Hospital & Research Centre, Kolar, during the period from JANUARY 2012 to AUGUST 2014. It was a prospective study. Women presenting for evaluation of palpable breast lump underwent assessment by clinical examination, mammography and FNAC and got the Triple Test Scoring done. All patients who underwent complete TTS at our institution were entered into the study. All patients were subjected to necessary surgery, post TTS and followed up with histopathology of the specimen. A structured proforma was used to collect relevant information from each patient selected. In our study the mean age of the patients was found to be 46.12 ± 11.48 years, most of the patients were in the age group of 35-45 years (60%). Positive family history was found in 17%. Patients on an average took 6 months to seek medical help after recognition of the breast lump. Most common location of breast lump was upper outer quadrant (39%). Out of 9 cases with suspicious interpretation in clinical diagnosis: 5 were diagnosed to be benign and 4 were diagnosed as malignant. Two cases which were diagnosed clinically as benign turned out to be malignant on HPE. Out of 5 cases with suspicious interpretation in FNAC: 2 were diagnosed to be benign and 3 were diagnosed as malignant. One case which was diagnosed as benign turned out to be malignant on HPE. Out of 6 cases with suspicious interpretation in mammography all were diagnosed as malignant. Three cases which were diagnosed as benign turned out to be malignant on HPE. All the cases diagnosed as malignant with TTS were proved malignant by HPE, all cases diagnosed as benign were proved benign on HPE, one case with TTS of 5 required a further test in form of biopsy for confirmation, and it turned out to be benign. The study clearly demonstrates the superiority of TTS over other components of triple assessment or all of them put together. A TTS of </=4 is consistent with a benign lesion; a TTS of >/= 6 indicates malignancy. Only in patients in whom TTS score is 5, biopsy is recommended to obtain a definitive diagnosis. Thus a standard protocol can be developed, for the management of breast lump even with discordant results obtained via triple test assessment, which can be followed universally, thus empowering surgeon to go ahead in managing breast lump effectively and confidently. Keywords: Triple Test Score, Triple Assessment, Breast lump

Authors and Affiliations

Dr. Pawan Katti, Dr. Anupam Choudhary, Dr. Sreeramulu P. N, Dr. Vijay Agrawal

Keywords

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