A Study of Modified Triple Test Score for Assessment of Palpable Breast Lump

Breast lump is a common complaint of women presenting to surgeons. Although most of them are benign, careful evaluation, exact diagnosis and definite treatment is mandatory to rule out cancer.  Young women are conventionally evaluated by triple test score which consists of clinical breast examination, mammography and fine needle aspiration biopsy. The sensitivity of mammography is low in young breast owing to its increased glandular component. Ultrasonography can be used for evaluation and diagnosis these breast lumps with sensitivity and specificity more than 80%. This study evaluated the efficacy of ultrasound instead of mammography in the conventional ‘triple test score’ for diagnosis of palpable breast lumps in young females and compare the result with open biopsy. 50 females with breast mass, of the age group 15 to 60 years were selected randomly and assessed by clinical breast examination, local ultrasonography of both breasts and fine needle aspiration biopsy to calculate a ‘modified triple test score’.  The ‘modified’ score was calculated by assigning score 1 for benign, score 2 for suspicious and score 3 for malignant results in each component and adding them up. All the masses were thereafter evaluated by open biopsy with consent. Score of 4 or less is interpreted as benign, 5 as inconclusive/equivocal, 6 or more as malignant in Modified Triple Test Score.  In the study, out of 50 patients 41 scored 3 or 4 points; all of which were benign, 3 scored 5 points; of which 1 was malignant and 6 scored 6 or more points; all of which were malignant. In our study we studied the results of score Points along with the final histopathology of the respective patient. Breast masses with a MTTS of 7 or more points were accurately diagnosed as malignant, thus a score of 7 or more points can proceed to definitive therapy, masses scoring 4 or less points were all benign could be safely observed and masses scoring 5 points need further evaluation with clinical examination and open biopsy. The MTTS is as accurate as conventional TTS in evaluation of breast masses in Young females and can avoid unnecessary evaluation. The score was particularly found to be useful for evaluation and analysis of breast lumps in young females.