Abstract
Background: Triple assessment is the standard for diagnosing breast lumps, involving clinical examination, breast imaging, and tissue diagnosis. Developed by Arden Morris et al. in 1998, the Triple Test Score evaluates palpable breast masses through clinical examination, mammography, and cytology. We used a modified triple test score with clinical examination, breast ultrasound, and core needle biopsy, aiming for rapid and accurate diagnosis for effective patient management.
Aims: Compare the Modified Triple Test Score across two biopsy guidance techniques for managing palpable breast lumps at Ahmadu Bello University Teaching Hospital, Zaria.
Methods: This randomized controlled study at Ahmadu Bello University Teaching Hospital in Zaria, Nigeria, involved patients divided into Group A for palpation-guided core needle biopsy and Group B for ultrasound-guided core needle biopsy. All patients underwent surgical biopsies. True positives, defined by concordant malignant findings, were exempt from open surgical biopsy to initiate oncologic multimodal therapy, including mastectomy. Definitive mastectomy histology reports replaced surgical biopsy results, with data analyzed using SPSS version 21.
Results: Data from 80 patients were analyzed, with 40 patients in each core needle biopsy group. The ages ranged from 18 to 72, with the peak age group (20-29 years) comprising 29 patients (36.3%). The Modified Triple Test Score was calculated using clinical breast examination, ultrasound, and core needle biopsy. In the palpation-guided group, the clinical breast examination had a sensitivity of 90.0% and a specificity of 77.8%. The breast ultrasound scan had a sensitivity of 100% and a specificity of 90.9%, and the core needle biopsy showed a sensitivity of 94.7% and a specificity of 100%, achieving a combined Modified Triple Test Score of 100%. In the ultrasound-guided group, the sensitivity and specificity of the clinical breast examination were 90.5% and 100%, respectively. The breast ultrasound scan and core needle biopsy achieved 100% sensitivity and specificity, with a combined Modified Triple Test Score of 100%.
Conclusion: This study confirms the value of the modified triple test score in evaluating breast lumps, demonstrating high accuracy for both core needle biopsy techniques when combined scores are used.