Accuracy of the “Triple Test” in the Diagnosis of Palpable Breast Masses in Saudi Females

Abstract

Background:For patients who present to clinicians with palpable breast lesions, the "triple test:" (physical examination, mammography and fine-needle aspiration cytology) can be employed to provide accurate diagnosis. In this study, the sensitivity, specificity and predictive values of triple test components were studied separately and in combination. Material and Methods: During the study period (from January 1998 to December 1999), 140 patients with palpable breast masses were subjected to all components of the triple test followed by confirmatory open biopsy. Results: Physical examination showed 82.6% sensitivity, 97.3% specificity and 86.4% positive predictive value. Mammography showed 87.5% sensitivity, 97.3% specificity and 87.5% positive predictive value and fine-needle aspiration cytology (FNAC) showed 91.7% sensitivity, 100% specificity and 100% positive predictive value in concordant cases (elements had either all malignant or all benign results). Conclusion:The triple test was 100% accurate in the diagnosis of palpable breast lesions when all three elements were concordant. Based on these results, we recommend elimination of the confirmatory open biopsy, which will result in reduced expenses and morbidity compared with open biopsy.

Diagnostic Accuracy of FNAC in Evaluation of Breast Lumps

“…In a study done by Philip J Drew et al [12] , sensitivity of fine-needle aspiration cytology was 79.1% and specificity of 97%.the specificity is similar to our study. Al-Mulhim et al [13] , in a study to assess accuracy of the "triple test" found that fine-needle aspiration cytology (FNAC) showed 91.7% sensitivity, 100% specificity and 100% positive predictive value.…”

Triple Test Score as an Evaluating Factor for Palpable Breast Lump.

“…There are numerous reports that if the results of clinical assessment, mammography and FNAC are all combined, the accuracy of diagnosis reaches 100% 4 . Furthermore these techniques provide information on tumor size, number, extent and grade pre-operatively 5 .…”

Metanálise do uso de redes bayesianas no diagnóstico de câncer de mama

“…Regarding economics, some studies have shown that the women treated in public institutions have more advanced stages of the disease, less access to modern therapies, and a lower survival rate than the patients treated in private institutions 43,44 . The triple test (physical examination, mammography, and cytology by fine needle aspiration) has been employed as a method to accurately diagnose palpable breast lesions.…”

“…The triple test (physical examination, mammography, and cytology by fine needle aspiration) has been employed as a method to accurately diagnose palpable breast lesions. When the three diagnostic methods are consistent, the elimination of biopsy as a confirmatory test is usually recommended and can result in reduced spending 43 . In this context, artificial intelligence techniques, such as Bayesian networks using above characteristics, now represent a reality and may decrease the uncertainty present in biopsies derived from suspicious nodules, enabling the reduction of public health costs 43,44 .…”