Usefulness of the triple test score for palpable breast masses

Katherine T. Morris, Rodney Pommier, Arden Morris, Waldemar A. Schmidt, Gregory Beagle, Priscilla W. Alexander, Suellen Toth-Fejel, Josh Schmidt, John Vetto

    Research output: Contribution to journalArticle

    39 Citations (Scopus)

    Abstract

    Hypothesis: The triple test score (TTS) is useful and accurate for evaluating palpable breast masses. Design: Diagnostic test study. Setting: University hospital multidisciplinary breast clinic. Patients: Four hundred seventy-nine women with 484 palpable breast lesions evaluated by TTS from 1991 through July 2000. Main Outcome Measures: Physical examination, mammography, and fine-needle aspiration were each assigned a score of 1, 2, or 3 for benign, suspicious, or malignant results; the TTS is the sum of these scores. The TTS has a minimum score of 3 (concordant benign) and a maximum score of 9 (concordant malignant). The TTS was correlated with subsequent histopathologic analysis or follow-up. Interventions: The TTS was prospectively calculated for each mass. Lesions with a TTS greater than or equal to 5 were excised for histologic confirmation, whereas lesions with scores less than or equal to 4 were either excised (n = 60) or followed clinically (n = 255). Results: All lesions with TTS less than or equal to 4 were benign on clinical follow-up, including 8 for which the fineneedle aspiration was the suspicious component. Of the 60 biopsied lesions, 51 were normal breast tissue, 4 showed fibrocystic change, 1 was a papilloma, and 4 were atypical hyperplasia. All lesions with a TTS greater than or equal to 6 (n= 130) were confirmed to be malignant on biopsy. Thus, a TTS less than or equal to 4 has a specificity of 100% and a TTS greater than or equal to 6 has a sensitivity of 100%. Of the 39 lesions (8%) with scores of 5, 19 (49%) were malignant, and 20 (51%) were benign. Conclusions: The TTS reliably guides evaluation and treatment of palpable breast masses. Masses scoring 3 or 4 are always benign. Masses with scores greater than or equal to 6 are malignant and should be treated accordingly. Confirmatory biopsy is required only for the 8% of the masses that receive a TTS of 5.

    Original languageEnglish (US)
    Pages (from-to)1008-1013
    Number of pages6
    JournalArchives of Surgery
    Volume136
    Issue number9
    StatePublished - 2001

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    Breast
    Biopsy
    Papilloma
    Mammography
    Fine Needle Biopsy
    Routine Diagnostic Tests
    Physical Examination
    Hyperplasia
    Outcome Assessment (Health Care)

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Morris, K. T., Pommier, R., Morris, A., Schmidt, W. A., Beagle, G., Alexander, P. W., ... Vetto, J. (2001). Usefulness of the triple test score for palpable breast masses. Archives of Surgery, 136(9), 1008-1013.

    Usefulness of the triple test score for palpable breast masses. / Morris, Katherine T.; Pommier, Rodney; Morris, Arden; Schmidt, Waldemar A.; Beagle, Gregory; Alexander, Priscilla W.; Toth-Fejel, Suellen; Schmidt, Josh; Vetto, John.

    In: Archives of Surgery, Vol. 136, No. 9, 2001, p. 1008-1013.

    Research output: Contribution to journalArticle

    Morris, KT, Pommier, R, Morris, A, Schmidt, WA, Beagle, G, Alexander, PW, Toth-Fejel, S, Schmidt, J & Vetto, J 2001, 'Usefulness of the triple test score for palpable breast masses', Archives of Surgery, vol. 136, no. 9, pp. 1008-1013.
    Morris KT, Pommier R, Morris A, Schmidt WA, Beagle G, Alexander PW et al. Usefulness of the triple test score for palpable breast masses. Archives of Surgery. 2001;136(9):1008-1013.
    Morris, Katherine T. ; Pommier, Rodney ; Morris, Arden ; Schmidt, Waldemar A. ; Beagle, Gregory ; Alexander, Priscilla W. ; Toth-Fejel, Suellen ; Schmidt, Josh ; Vetto, John. / Usefulness of the triple test score for palpable breast masses. In: Archives of Surgery. 2001 ; Vol. 136, No. 9. pp. 1008-1013.
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    abstract = "Hypothesis: The triple test score (TTS) is useful and accurate for evaluating palpable breast masses. Design: Diagnostic test study. Setting: University hospital multidisciplinary breast clinic. Patients: Four hundred seventy-nine women with 484 palpable breast lesions evaluated by TTS from 1991 through July 2000. Main Outcome Measures: Physical examination, mammography, and fine-needle aspiration were each assigned a score of 1, 2, or 3 for benign, suspicious, or malignant results; the TTS is the sum of these scores. The TTS has a minimum score of 3 (concordant benign) and a maximum score of 9 (concordant malignant). The TTS was correlated with subsequent histopathologic analysis or follow-up. Interventions: The TTS was prospectively calculated for each mass. Lesions with a TTS greater than or equal to 5 were excised for histologic confirmation, whereas lesions with scores less than or equal to 4 were either excised (n = 60) or followed clinically (n = 255). Results: All lesions with TTS less than or equal to 4 were benign on clinical follow-up, including 8 for which the fineneedle aspiration was the suspicious component. Of the 60 biopsied lesions, 51 were normal breast tissue, 4 showed fibrocystic change, 1 was a papilloma, and 4 were atypical hyperplasia. All lesions with a TTS greater than or equal to 6 (n= 130) were confirmed to be malignant on biopsy. Thus, a TTS less than or equal to 4 has a specificity of 100{\%} and a TTS greater than or equal to 6 has a sensitivity of 100{\%}. Of the 39 lesions (8{\%}) with scores of 5, 19 (49{\%}) were malignant, and 20 (51{\%}) were benign. Conclusions: The TTS reliably guides evaluation and treatment of palpable breast masses. Masses scoring 3 or 4 are always benign. Masses with scores greater than or equal to 6 are malignant and should be treated accordingly. Confirmatory biopsy is required only for the 8{\%} of the masses that receive a TTS of 5.",
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    AU - Pommier, Rodney

    AU - Morris, Arden

    AU - Schmidt, Waldemar A.

    AU - Beagle, Gregory

    AU - Alexander, Priscilla W.

    AU - Toth-Fejel, Suellen

    AU - Schmidt, Josh

    AU - Vetto, John

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