Riffat Raja, Hina Hanif, Hassan Mahmood.
Accuracy of Triple Assessment in Diagnosis of Breast Cancer in Women More than 40 Years of Age.
J Rawal Med Uni Jan ;22(2):112-5.

Background: To determine the diagnostic accuracy of triple assessment in diagnosis of breast cancer in women more than 40 years keeping histopathology as gold standard. Methods: In this cross sectional study, women with a breast lump or change in the texture of breast with an age range of 40-70 years were included. Detailed physical and breast examination and mammography followed by FNAC were performed. Mammography of breast consists of two standard views , i.e., lateral oblique (MLO) and a craniocaudal view (CC). Sensitivity, specificity, positive predictive value and negative predictive value and accuracy of triple assessment were calculated. Results: There were 49.5% patients who were labelled as malignant. Mammogram showed 69.7% as malignant. On FNAC 64.8% were labelled as malignant. Results of triple assessment showed 72.4% as malignant. Histopathology results showed 73.3% as malignant, thus showing that in overall study population 71.5% were true positives, 25.7% were true negatives, 1% were false positives and 2.0% were false negatives. The study findings revealed that sensitivity, specificity, PPV, NPV and accuracy of triple assessment in diagnosing breast cancer is 97.4%, 96.4%, 98.7%, 93.1% and 97.2% respectively. Conclusion: Triple assessment allows detection of malignancy in palpable breast lumps with acceptable sensitivity, specificity, positive predictive value, negative predictive value and accuracy.

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