Role of the Triple Test in the Evaluation of Breast Mass

Abstract

This prospective study was carried out on 210 female patients with a diagnosis of breast mass admitted to the surgical unit of Al-Diwaniya Teaching Hospital over a period of 2 years from January 2013 to December 2014. Each patient was assessed by the triple test which includes physical examination, imaging studies , and fine needle aspiration cytology (FNAC). The results of each modality of the triple test were classified as benign, suspicious or malignant and then compared with the final diagnosis obtained by the histopathological examination. Breast mass was more common in the fourth decade of life (40.47 %), and the most common associated clinical feature was pain in 30.95 % of cases. Fibroadenoma was the most common benign breast mass ( 41.9 %), while invasive ductal carcinoma was the most common malignant breast mass (27.14 %). The most accurate element of the triple test was FNAC with
a concordance rate of 0.89 (almost perfect agreement),while physical examination was the least accurate element with a concordance rate of 0.62(substantial agreement). The concordance rate of the triple test was 0.94 (almost perfect agreement) and it was higher than that of any modality used in the triple test. The sensitivity of the triple test was 93.85 % , specificity 99.31 % , positive predictive value (PPV) 98.39 %, negative predictive value (NPV) 97.30 % , and accuracy 97.62 % , and again these figures were higher than those of the elements of the triple test.So that the triple test can be safely used as an accurate and least invasive diagnostic test in the evaluation of patients with breast mass and to detect patients with breast cancer