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A study of accuracy of triple assessment as a clinical tool for the diagnosis of a palpable breast lump

Keyur Narendrabhai Surati, Kaushal Suthar, Brijesh Parekh, Jainam Shah.




Abstract

Background: Diseases related to breast are the highest in this country as well as in the world. Various types of lesion from inflammation to carcinoma can affect breast. Some lesions are common in young females while others in elderly age group. Early presentation and prompt diagnosis is essential to relieve anxiety of non-neoplastic conditions, and in case of carcinoma, it can save the patient from metastases. In this study many cases related to breast lesions from the region are reported in the surgery clinics of this institute and various breast diseases are being managed in the clinical departments. For disease confirmation, many diagnostic procedures are recommended with aims to help in decision for surgical treatment. To study prevalence of various breast disease condition coming to our hospital and their management. Analysis of pattern and prevalence will be a valuable guideline for clinicians of this location to compare with that of others. This study was to evaluate the accuracy of Triple assessment (physical examination, mammography and fine needle aspiration cytology) as a clinical tool for the diagnosis of a palpable breast lump.

Aims & Objective: (1) To study incidence for breast disease; (2) To study etiopathogenesis of it; (3) To study patient presentation and manifestation; (4) To study management of various breast diseases; and (5) To study various modalities of treatment.

Material and Methods: This prospective study was carried out in the department of surgery during period from 1st march 2011 to 28th February 2012 in indoor and outdoor patients. Each patient was study in detail with relevant clinical history, examination, mammography and histological findings and management. The study comprised of total 100 patients of breast disease treated with various modalities.

Results: In the study of total 100 cases, inflammatory conditions were present in 15%, fibrocystic lesion 35%, fibroadenoma 20%, gynaecomastia 2% and carcinoma 10%. This comparative study reported data by clinical analyses, mammography and histological findings in 100 women with ages from 18 to 60. Malignant carcinoma found in 10% of cases while benign breast disease and other condition found in 90% of cases.

Conclusion: Fibrocystic disease was the commonest lesion in this study with 30 years as the average age of presentation. Malignancy was detected above 47 years of age. Ninety patients with breast lumps interpreted by Triple Assessment as benign correlated with the histopathological findings whereas of 10 malignant lumps. This gives Triple Assessment an overall accuracy of 100% in our study.

Key words: Fibro Adenoma; Fibrocystic Disease; Gynecomastia; Breast Cancer; Triple Assessment






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