Diagnostic accuracy of the modified triple test in evaluation of palpable breast masses among women under 40 years attending Mulago Hospital

Abstract

Background: Breast lumps remain the commonest presentation among women at outpatient clinics in Uganda. However, the diagnostic utility of the modified triple test, MTT (physical breast examination, breast ultrasound, and Fine needle aspiration cytology) for evaluation of palpable breast lumps remains unknown. Objectives: 1) To determine the sensitivity of the modified triple test for evaluation of palpable discrete breast masses in women under 40 years. 2) To determine the specificity of the modified triple test for evaluation of palpable discrete breast masses in women under 40 years. 3) To determine the diagnostic accuracy of the modified triple test for evaluation of palpable discrete breast masses in women under 40 years. Methods: A cross-sectional study was conducted for 82 patients enrolled at the Mulago National Referral Hospital breast and endocrine outpatient clinic. A physical breast examination, breast ultrasound, fine needle aspiration cytology, and core biopsy were performed for every patient. The core biopsy /histopathology report was considered the gold standard. The sensitivity, specificity, positive and negative predictive values, and the diagnostic accuracy of the modified Triple test were determined using STATA 17.0 software. Results: The majority of the respondents lived in the urban area, 65/82 (79.3%) and the median age of the participants was 25.5 years with interquartile range 20-33. The sensitivity of the MTT was 100 % (95 %CI: 75.3-100) and the specificity of the MTT was 97.1 % (95 %CI: 89.9-99.9). The overall diagnostic accuracy of the MTT was 97.56 % (95 % CI: 91.5-99.7) Conclusions and recommendations: This study proposed that MTT has high sensitivity, specificity, and accuracy in the diagnosis of breast lesions among women under 40 years old. We recommend further studies with larger sample sizes and multiple centers to evaluate the feasibility of implementing MTT across Uganda and other settings. Keywords: breast, diagnostic accuracy, sensitivity, specificity, modified triple test.