Clinicopathological Correlation of Modified Triple Test Components with Histopathological Subtypes in Patients Presenting with Breast Lump

Abstract

Background: Breast lumps are a common clinical presentation, with timely differentiation between benign and malignant lesions being critical for appropriate management. The Modified Triple Test Score (MTTS), integrating clinical examination, imaging, and cytopathology, offers a structured, cost-effective, and reproducible method for preoperative evaluation of breast masses, particularly in low-resource settings.

Objectives: To assess the clinicopathological correlation of MTTS components with final histopathological subtypes in patients presenting with palpable breast lumps, and evaluate its diagnostic performance in identifying malignancy.

Methods: This prospective observational study was conducted at Shri Mahant Indiresh Hospital, Dehradun, between January 2023 and March 2024. Sixty female patients over 18 years of age with palpable breast lumps were enrolled. Each underwent clinical breast examination, radiological assessment (sonomammography), and FNAC or core biopsy. Findings were scored using the MTTS system and compared with post-excisional histopathological examination (HPE). Data were analyzed using SPSS v23, applying Chi-square and Fisher’s exact tests with p < 0.05 as significant.

Results: MTTS categorized 70% of cases as malignant and 30% as benign. Histopathological analysis revealed fibroadenoma and invasive ductal carcinoma as the most common lesions (20% each), followed by lobular carcinoma, phyllodes tumor, intraductal papilloma, and fibrocystic changes (15% each). High MTTS scores showed strong concordance with malignant histology, supporting its diagnostic reliability.

Conclusion: MTTS is a valuable, accurate, and accessible diagnostic modality that demonstrates strong agreement with histopathological findings, facilitating early detection and triage of breast lesions in clinical practice.