Triple test score
A diagnostic test used in breast cancer detection
Triple test score (TTS) is a diagnostic method used in the evaluation of breast abnormalities, particularly in the detection of breast cancer. It combines three diagnostic components: clinical breast examination, mammography, and needle biopsy. Each component is scored, and the combined score helps determine the likelihood of malignancy.
Components
Clinical Breast Examination
A clinical breast examination (CBE) is performed by a healthcare professional to assess any palpable abnormalities in the breast tissue. The examination involves visual inspection and manual palpation to detect lumps, skin changes, or nipple discharge. The findings are scored based on the level of suspicion for malignancy.
Mammography
Mammography is an imaging technique that uses low-dose X-rays to examine the breast. It is a crucial component of the triple test score, as it can reveal masses or calcifications that may not be palpable. The mammographic findings are scored according to the Breast Imaging-Reporting and Data System (BI-RADS) classification.
Needle Biopsy
A needle biopsy involves the removal of a small sample of breast tissue for histological examination. This procedure can be performed using a fine needle aspiration (FNA) or a core needle biopsy. The biopsy results provide definitive information about the presence of cancer cells and are scored based on the pathology report.
Scoring and Interpretation
Each component of the triple test is scored on a scale, typically from 1 to 5, with higher scores indicating a greater likelihood of malignancy. The scores from the clinical examination, mammography, and biopsy are combined to form the triple test score. A total score of 3 to 5 suggests a low probability of cancer, while a score of 6 to 9 indicates a moderate to high probability. A score of 10 to 15 is highly suggestive of malignancy, warranting further investigation or intervention.
Advantages and Limitations
The triple test score is valued for its ability to provide a comprehensive assessment of breast abnormalities by integrating clinical, radiological, and pathological data. It helps reduce unnecessary surgeries by identifying benign conditions that do not require invasive treatment. However, the accuracy of the TTS depends on the quality of each component, and false negatives can occur if any part of the test is not performed optimally.
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References
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Contributors: Prab R. Tumpati, MD