Original Research Article
Year: 2017 | Month: July | Volume: 7 | Issue: 7 | Pages: 53-59
Predictability Score of Routine Screening Techniques and Triple Test in Diagnosis of Breast Lesions in a Tertiary Care Hospital
Dr. Prakash S.Ghadi1, Dr. Manjushree P. Ghadi2, Dr. Chandrashekhar Gattani3, Dr. Akshay Tyagi4
1Professor of Pathology, 2Asst. Professor of Pathology, 3Professor of Radiology, 4Resident in Pathology,
MVP’s Dr. Vasantrao Pawar Medical College, Adgaon, Nashik – 422 003.
Corresponding Author: Dr. Prakash S.Ghadi
Introduction: Increasing incidence of breast cancer, higher awareness in the society about this condition and easy availability of screening procedures has effected increased number of cases with breast-related symptoms for evaluation in clinical practice. Mammography and fine needle aspiration cytology are the main screening tests in evaluation of any breast lump. This study is carried out to compare the predictability of various breast lesions by individual screening test and by combined diagnostic approach utilizing Triple Test Score (TTS).
Aims and Objectives: The aim was to evaluate the role of TTS in palpable breast masses over individual screening test.
Materials and Methods: This prospective study was carried out from April 2015 to December 2016 in a tertiary care hospital in rural area as a combined effort involving the Departments of Pathology, Surgery and Radiology of a medical college. All cases were first evaluated clinically and then referred for mammography and FNAC of the breast mass, which were later diagnosed by histopathological examination. In the study period of 21 months, total 45 cases were studied where all three parameters of screening were utilized, i.e. clinical examination, mammography and FNAC followed by histopathological confirmation. TTS was then calculated in the evaluation of these lesions. The statistical parameters of sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) were calculated separately for malignant and non-malignant condition for each parameter of screening modality. Also a diagnosis match percentage was calculated for each parameter of screening modality, including TTS, irrespective of nature of disease (malignant or non-malignant) as per final histopathological diagnosis. This statistical data was compared to find out the better diagnostic modality of any breast lesion.
Results: Sensitivity, specificity, PPV and NPV was the best (>92 %) irrespective of nature of the disease in TTS as compared to other screening modalities. Also the diagnosis match showed the best correlation with TTS (93.3 %) than clinical (66.7 %), radiological (51.1 %) or cytology (84.4 %) score.
Conclusions: Triple test (TTS) is a very reliable method of evaluation for any palpable breast masses, whether benign or malignant, than utilizing fine needle aspiration cytology or mammography alone as a screening test. Histological correlation may be avoided before definitive treatment if Triple Test Score (TTS) is applied to all cases of breast lumps. However, it will require multiple as well as large scale studies from different part of the world to be implemented as a protocol for diagnosis and treatment.
Key words: Breast lump, Bi-rad score, Mammographic screening, Fine needle aspiration cytology breast, Triple test, Triple test score