TRIPLE TEST SCORE AS AN EVALUATING FACTOR FOR PALPABLE BREAST LUMP.

Background: Breast lump is a very sensitive issue and cause of great worry and anxiety to the patient, so a reliable, preferably non-invasive and prompt diagnosis is required. Breast lump should be managed effectively and confidently with a proper protocol plan, ensuring early and best possible treatment for every patient. Triple test assessment was a major breakthrough in this direction, which streamlined the management of palpable breast lump. When all the components of triple test assessment which are Clinical Examination, FNAC, Mammography point to one possibility (are concordant) then the diagnosis is almost certain and management can be confidently planned in such a situation. But if there is discordance among the components of triple test, then what should be the next step in the management plan is the question to be answered. This is where triple test score shows us the path. Objective of the Study: ? To perform Triple Test Score in patients with breast lump. ? To perform Histopathological Examination (HPE) of the breast lump resected. ? To evaluate the efficacy of TTS in comparison with HPE. ? To develop a standard protocol for management of breast lump especially when discordant results are obtained from triple assessment. Materials and Methods: Study was conducted on 200 patients presenting with breast lump to the department of General Surgery at Tertiary Care Teaching Hospital, during the period from January 2012 to Dec 2016. It was a prospective study. Women presenting for evaluation of palpable breast lump underwent assessment by clinical examination, mammography and FNAC and got the Triple Test Scoring done. All patients who underwent a complete TTS at our institution were entered into the study. All patients were subjected to necessary surgery, post TTS and followed up with Histopathology of the specimen. A structured proforma was used to collect relevant information from each patient selected. Results: In our study the mean age of the patients was found to be 46.12 ? 1 1.48 years, most of the patients were in the age group of 35-45 years (60%). Positive family history was found in 17%. Patients on an average took 6 months to seek medical help after recognition of the breast lump. Most common location of breast lump was upper outer quadrant. 38 cases were malignant and 148 were benign 14 were intermediate group commonest lump was fibroadenoma, Histopathology was 100% specific in both the groups of study conclusions were made based on clinical radiological and pathological assessment. Conclusion: The study clearly demonstrates the superiority of TTS over other components of triple assessment or all of them put together. A ITS of /=6 indicates malignancy. Only in patients in whom TTS score is 5, biopsy is recommended to obtain a definitive diagnosis. Thus a standard protocol can be developed, for the management of breast lump even with discordant results obtained via triple test assessment, which can be followed universally, thus empowering surgeon to go ahead in managing breast lump effectively and confidently.