The triple test: A cost-effective diagnostic tool

The triple test (TT), comprising fine-needle aspiration biopsy (FNAB), physical examination, and mammography, is a financially important diagnostic modality in the capitation era. During 31 months, 43 patients in the Multidisciplinary Breast Clinic had 46 temporally congruent physical examinations, mammograms, FNABs, and biopsies with histopathologic results. False-negative rates for physical examination were 4.3%; for mammography, 2.2%; and for FNAB, 2.3%. False-positive rates for physical examination were 15.2%; for mammography, 15.2%; and for FNAB, 0. The TT results presented in this study are essentially identical to those reported elsewhere. The TT is demonstrably more accurate than physical examination or mammography, either alone or in various double combinations. Monetary savings are substantial when FNAB data are used in patient management algorithms based upon the TT. This is the fourth and final article in the CE Update series on cytology. Look for the CE Update exam in this issue.