A Prospective study of Modified Triple Assessment in Breast Lumps

Naresh Kumar, R (2019) A Prospective study of Modified Triple Assessment in Breast Lumps. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

INTRODUCTION: “BREAST LUMP” is one of the common complaints in women coming to the surgical outpatient department. Even though most of the lumps were benign, all cases needs to be evaluted properly to rule out malignancy. In India, Breast carcinoma is the 2nd most common malignancy in women. Incidence increasing every year which ranges approximately 19-33%. Incidence of cancer breast shows “AGE SHIFT” over the past twenty years in India that is incidence increased from 7 to 15% in the age group of 30-40 years. Advanced breast cancer stage is associated with high morbidity and mortality. Hence early stage disease should be promptly differentiated from benign disease for proper management at the earliest with proper assessment. Breast lump assessment should be an ordered one. So, sequential evaluation named “TRIPLE TEST” was formalized. This was introduced with an aim to avoid expensive potentially morbid negative biopsy and also to let the clinician to proceed directly for definitive management without further investigations. Triple test proved to be a gold standard diagnostic modality in lump breast. AIM OF THE STUDY: To study .the diagnostic accuracy of modified triple test. Components of .Modified Triple Test: Clinical examination, Imaging .study - ultrasound, Tissue diagnosis .- FNAC/CNB. Scope of this .study: 1. To assess .the individual component diagnostic accuracy of MTT. 2. To assess .overall diagnostic accuracy of MTT. 3. To explore .the results against HPE report of Incisional/ Excisional biopsy. MATERIALS AND METHODOLOGY: Patients attending Department of General Surgery OPD with a palpable breast lump was subjected to the study. Place of study: Department of General Surgery, Government Royapettah Hospital, Kilpauk Medical College, Chennai-14. Inclusion criteria: Female patients with palpable. breast lump, Age group of more than 15 years. Exclusion criteria: Male patients, Female patients with clinically evident. advanced stage. breast disease As per inclusion and exclusion criteria study people.. were selected. Total numbers of 50 patients were included in the study. Duration of Study: March 2018 to August 2018. CONCLUSION: In recent years in India, westernization and increased sedentary life style resulted in increased incidence of breast can.cer. With present knowledge and public awareness about cancer breast, the cancer phobia is increased in among the female. Our study includes assessment of individual and combined diagnostic accuracy of Modified Triple Test in women of more than 30 years of age with palpable breast lump. Study goes on with initial assessment with clinical examination, then imaging with Ultrasound and finally cytological interpretation of FNAC slides. Clinician, Radiologist and pathologist had fine collaboration during the study. Diagnostic accuracy of MTT indirectly indicates the experience and skill of the clinician, radiologist and pathologist. On data analysis the study results showed that clinical examination is least sensitive in diagnosing the malignancy, hence breast lump requires further investigations which on combination with other two component the sensitivity increased to 100%. Advanced technology Ultrasonogram good in characterization of breast lump which had high sensitivity and NPV of 100%. FNAC had a high specificity and positive predictive value of 100% which was highly comparable to previous study results.

Item Type: Thesis (Masters)
Additional Information: Reg.No>221611162
Uncontrolled Keywords: Modified Triple Assessment, Breast Lumps, Prospective study.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 02 Sep 2019 07:39
Last Modified: 08 Sep 2019 09:12
URI: http://repository-tnmgrmu.ac.in/id/eprint/11421

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