A study on diagnostic accuracy of modified triple assessment in palpable breast lumps

Radha K., Uma M.


Background: Breast (mammary gland) is a distinguishing feature of class Mammalia. Patients commonly present, complaining of a lump in the breast, pain, and nipple discharge. Although the most common cause of symptoms is benign breast diseases. But as the life expectancy is increasing incidence of carcinoma breast is also increasing. 1.To assess the individual component diagnostic accuracy of MTT.

Methods: This was a cross-sectional study involving 50 female patients with palpable breast lumps attending the Surgical Out-Patient of the Department of General Surgery, Government Royapettah Hospital, Kilpauk medical college, Chennai between June 2020 and May 2021 over 12 months, who underwent clinical breast examination (CBE), ultrasonography (USG), and fine-needle aspiration cytology (FNAC).

Results: In the study population, the breast tumor is common on the left side account for about overall 53%age of patients. The bilateral tumors are the least common. Fibroadenoma is the most common benign tumor. In our study also similar results were obtained. The next common benign tumor among the study group is a fibrocystic disease of the breast. Analysis of the above results shows that though FNAC has a sensitivity of 90%, it has a positive predictive value of 100%. The study shows that the combined results of the Modified Triple Test are comparable to the histopathological diagnosis of the biopsy specimen.

Conclusions: Our study includes assessment of combined diagnostic accuracy of Modified Triple Test in women of more than 30 years of age with a palpable breast lump.


Breast lumps, Clinical breast examination, Fine-needle aspiration cytology, Modified triple test, Ultrasonography

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Vetto JT. Diagnosis of palpable breast lesions in younger women by the modified triple test is accurate and cost-effective Arch Surg. 1996;131(9):972-4.

Purasiri P. A novel diagnostic index for use in the breast clinic. J R Coll Surg Edinb. 1996;41(1):30-4.

Hermansen C. Diagnostic reliability of combined physical examination, mammography, and fine-needle puncture (“triple-test”) in breast tumors. A prospective study Cancer. 1987;60(8);1866-7.

Bassett LW. Use fullness of Mammography and Sonography in women Less than 35 years of Age’ Radiology. 1991;180:831-5.

Hermansen C. Diagnostic Reliability of combined physical Examination, Mammography, and Fine – Needle puncture (“Triple_ Test”) in Breast Tumours, Cancer. 1987;60:1866-71.

Frykberg ER, Kirby BI. Evolution of surgical principles and techniquesfor the management of breast cancer. In: Kirby BI, Copeland EM. Thebreast - Comprehensive management of benign and malignant disease,Vol. 2. 2nd ed. Philadelphia: W.B. Saunders Company. 1998;125:893-6.

Morris KT, Pommier RF, Morris A, Schmidt WA, Beagle G, Alexander PW et al. Usefulness of thetriple test score for palpable breast masses. Archive of Surgery. 2001;136:1008-13.

Morris A, Pommier RF, Schmidt WA, Shih RL, Alexander PW, Vetto JT. Accurate evaluation of palpablebreast masses by triple test score. Archives Surgery. 1998;133:930-4.

Vetto JT, Pommier RF, Schmidt WA, Eppich H, Priscilla W. Alexander. Diagnosis of palpable breast lesions in youngwomen by the modified triple test is accurate and cost-effective, Archives of Surgery. 1996;131:967974.

Morris KT, Vetto JT, Petty JK, Lum SS, Schmidt W, Toth - Fejel S et al. A new score for the evaluation ofpalpable breast masses in women under age 40. The American Journal of Surgery. 2002;184:346-7.

Bland K, Beenken SW, Copeland III EM. The Breast. Schwartz’s Principles of Surgery, Charles F. Brunicardi, McGraw Hill. 2005;470:475-77.

Donegan WL. Evaluation of a palpable breast mass. N Engl J Med. 1992;327(13):937-42.

Hermansen C, Poulsen SH, Jensen J. Diagnostic reliabilityof combined physical examination, mammography, and fine-needlepuncture (“triple-test”) in breast tumors: a prospective study. Cancer. 1987;60:1866-68.

Bassett LW, Ysrael M, Gold RH, Ysrael C. Usefulness of mammographyand sonography in women less than 35 years of age. Radiology. 1991;180(3):831-5.

Shetty MK, Shah YP, Sharman RS. Prospective evaluation of the value ofcombined mammographic and sonographic assessment in patients withpalpable abnormalities of the breast. J Ultrasound Med. 2003;22:263-68.