The Role of Triple Test Assessment in the Early Management of Breast Carcinoma
Abstract
ABSTRACT
Background: The incidence of breast cancer is increasing worldwide and among Iraqi women. Early detection and screening programs are necessary for the early diagnosis and management of the disease. Triple test assessment has become formalized as a scientific approach for the evaluation of breast cancer. It consists of clinical examination, imaging studies and biopsy.
Objective: To evaluate the accuracy of triple test assessment in the pre-operative diagnosis of patients with suspected breast cancer and to assess the impact of triple test assessment on detecting the disease in its early stages so that proper management can be implemented
Methods: This is a prospective study done including 276 patients over a one year period from Sept. 2010 to Sept. 2011 at Al-Yarmouk Teaching Hospital. All female patients who presented with a breast lump or other breast complaint were included. Clinical examination was done and if a breast lesion was suspected, a questionnaire form was filled and the patient referred to do imaging studies (mammography and ultrasonography). Any suspicious lesion was subjected to fine needle aspiration cytology and/or excisional biopsy to confirm the diagnosis. The surgical findings and surgical procedures were recorded. The final histopatholpgical diagnosis, grading of tumor, hormonal receptor status and clinical staging were documented.
Results: Of 218 patients who presented with breast lump, the application of triple assessment revealed the presence of malignancy in 112 (51.3%) patients. Excisional biopsy confirmed the diagnosis in 94 (83.9%) patients. All patients agreed to have surgery. Of those, 104 (92.8%) patients underwent modified radical mastectomy and 99 (88.3%) patients proved to have ductal cell carcinoma. According to clinical Columbia classification 59 (52.6%) were of stage A and 32 (28.5%) of stage B.
Conclusions: Triple test assessment is a reliable and sensitive approach to the problem of females with breast lump or suspected breast malignancy. It can contribute to the early detection of breast cancer so that a more optimal management can be implemented.
Copyright (c) 2012 Iraqi Medical Journal
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