Ngotho J, Githaiga J, Kaisha W
Department of Surgery, University of Nairobi, Kenya.
S Afr J Surg. 2013 May 3;51(2):58-60. doi: 10.7196/sajs.1176.
Palpable breast masses in young women, though usually benign, are a common source of anxiety. Current practice is assessment using the modified triple test (MTT). This entails clinical breast examination (CBE), ultrasound scans and cytological examination of a fine-needle aspiration biopsy specimen (FNAC). It is unclear whether it is necessary to utilise all three components in most patients.
We aimed to determine the diagnostic value of the MTT for the evaluation of palpable discrete breast masses in women under 35 years of age, and to assess the performance of its components when used individually or in combinations of two.
This was a cross-sectional study carried out between August 2010 and October 2010 in the breast and general surgical outpatient clinics at Kenyatta National Hospital, Nairobi, Kenya.
Fifty-eight patients presenting during the study period with palpable discrete breast masses satisfying the inclusion criteria were recruited. All patients had a CBE, ultrasound scans and FNAC. A core biopsy was performed as a reference standard. Main outcome measures. The test results of the MTT and its elements (CBE, ultrasonography and FNAC) were compared with the histological findings (the reference standard).
The age range of the 58 patients was 18 - 34 years (mean 25.5 years, standard deviation 5.1 years). Forty-five patients (77.6%) had concordant MTT results (agreement in all the three components). Concordant MTTs had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100%. Sensitivity, specificity, PPV and NPV were 100%, 92.3%, 60% and 100%, respectively, for CBE; 100%, 94.2%, 66.7% and 100%, respectively, for ultrasonography; and 100%, 98.1%, 83.3% and 100%, respectively, for FNAC. The combinations CBE plus ultrasound and CBE plus FNAC had sensitivities, specificities, PPVs and NPVs of 100%.
Use of the MTT for diagnosis of palpable breast masses in young women (
年轻女性可触及的乳腺肿块虽然通常为良性，但却是常见的焦虑源。目前的做法是采用改良三联检查法（MTT）进行评估。这包括临床乳腺检查（CBE）、超声扫描以及细针穿刺活检标本（FNAC）的细胞学检查。尚不清楚在大多数患者中是否有必要使用所有这三个组成部分。
我们旨在确定MTT对评估35岁以下女性可触及的孤立性乳腺肿块的诊断价值，并评估其各个组成部分单独使用或两两组合使用时的性能。
这是一项于2010年8月至2010年10月在肯尼亚内罗毕肯雅塔国家医院的乳腺及普通外科门诊进行的横断面研究。
招募了在研究期间出现可触及的孤立性乳腺肿块且符合纳入标准的58例患者。所有患者均接受了CBE、超声扫描和FNAC。进行了核心活检作为参考标准。主要结局指标。将MTT及其要素（CBE、超声检查和FNAC）的检测结果与组织学结果（参考标准）进行比较。
58例患者的年龄范围为18 - 34岁（平均25.5岁，标准差5.1岁）。45例患者（77.6%）的MTT结果一致（所有三个组成部分均一致）。结果一致的MTT的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）均为100%。CBE的敏感性、特异性、PPV和NPV分别为100%、92.3%、60%和100%；超声检查分别为100%、94.2%、66.7%和100%；FNAC分别为100%、98.1%、83.3%和100%。CBE加超声以及CBE加FNAC组合的敏感性、特异性、PPV和NPV均为100%。
MTT用于诊断年轻女性可触及的乳腺肿块（
