Usefulness of the triple test score for palpable breast masses

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

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


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
Issue number9
StatePublished - 2001

ASJC Scopus subject areas

  • Surgery


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