Efficacy of Modified Triple Assessment in Diagnosing Breast Lesions: A Prospective Observational Study

TL;DR

This study shows that a modified triple assessment test is highly effective in diagnosing breast lumps, especially in younger women with dense breast tissue.

Contribution

The study demonstrates the superior diagnostic accuracy of the modified triple test over individual methods in breast lesion evaluation.

Findings

The modified triple test achieved 100% sensitivity and 98.65% specificity in diagnosing breast lesions.

It outperformed individual diagnostic methods like clinical examination, ultrasound, and FNAC.

The approach reduces unnecessary biopsies and is suitable for resource-limited settings.

Abstract

Background: Breast lumps are a common clinical presentation, often causing significant anxiety due to the risk of malignancy. Early and accurate differentiation between benign and malignant breast lesions is essential for optimal patient management. The modified triple test (MTT), which replaces mammography with ultrasound in the traditional triple assessment test (TAT), offers a more effective diagnostic approach, particularly in younger women with dense breast tissue. This study evaluates the efficacy of MTT in diagnosing breast lesions.

Methods: A prospective observational study was conducted on 100 female patients aged 15 years and above presenting with palpable breast lumps at South Central Railway Hospital, Secunderabad, India. Patients underwent clinical examination, ultrasound (USG), and fine-needle aspiration cytology (FNAC), with histopathological examination (HPE) as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each modality.

Results: The majority of participants were in the 41-50 years age group (38%). Clinical examination demonstrated a sensitivity of 73.08% and specificity of 98.65%. Ultrasound exhibited a sensitivity of 57.69% and specificity of 98.64%. FNAC showed a sensitivity of 84.62% and specificity of 98.65%. MTT demonstrated 100% sensitivity, 98.65% specificity, and 96.30% PPV, significantly outperforming individual modalities.

Conclusion: The MTT is a highly accurate and reliable diagnostic approach for breast lump evaluation, reducing the need for unnecessary biopsies. Its high sensitivity and specificity make it a valuable tool for early breast cancer detection, especially in resource-limited settings.