The Modified Triple Test Score (MTTS) for a Palpable Breast Mass

 

NOTE: The original Triple Test Score is discussed above in 27.12.22. It scores mammographic changes rather than ultrasonographic findings.

 

Triple tests:

(1) physical examination

(2) ultrasonography

(3) fine needle aspiration (FNA)

Test	Finding	Points
physical examination	benign	1
	suspicious	2
	malignant	3
ultrasonography	benign	1
	suspicious	2
	malignant	3
fine needle aspiration	benign	1
	suspicious	2
	malignant	3

 

triple test score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 3

• maximum score: 9

• The higher the score, the more likely the lesion is malignant.

• A score >= 5 requires biopsy.

 

Triple Test Score	Interpretation (Morris et al)
3 or 4	benign
5	indeterminate; biopsy lesion
6 to 9	malignant

 

Performance:

• Ultrasonography may be preferable to mammography in women <= 45 years of age. This population tends to have a significant false negative rate on mammography.

• Many errors because a young woman is considered too young to have breast cancer. Any lesion should be considered potentially malignant until proven otherwise.

 

Limitations:

• The quality of the FNA sample definitely would affect the effectiveness of the method. Some practitioners have a lot more difficulty obtaining a good sample than others.