COMPARISION OF TRIPLE ASSESSMENT AND HISTOPATHOLOGY RESULTS IN DIAGNOSING BREAST LUMP

Background: Breast lumps constitute a major public health concern, given their potential to signify malignancy and the psychosocial distress they cause. Early and accurate diagnosis is paramount for timely intervention and optimal outcomes. Triple assessment comprisingclinical examination, imaging (mammography and/or ultrasound), and cytopathological evaluationhas long been advocated for its high diagnostic accuracy. However, histopathological examination of excised tissue remains the definitive standard, creating an ongoing debate about how precisely triple assessment aligns with final histopathology. Methods: We conducted a Retrospective, observational study conducted over two years (March 2023 April 2025) at Basaweshwar Teaching and General Hospital. Women aged 15 years and above presenting with a palpable breast lump were recruited. Each patient underwent clinical examination, imaging (mammography and/or ultrasound), and fine-needle aspiration cytology (FNAC) as part of the triple assessment. Histopathological evaluation of surgical specimens followed for definitive diagnosis. Data were statistically analyzed to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy. Results: Among 80 enrolled patients, the mean age was 40.2 years, with the majority presenting with a single, unilateral lump. Triple assessment was highly sensitive (94.4%) and specific (98.4%) PPV of 94.4%, NPV of 98.4%, and accuracy of 98.75%. False negatives occurred primarily in younger patients with dense breast tissue and,also likely due to overlap in cytological features of fibroepithelial lesions (e.g., fibroadenoma vs. phyllodes tumor). There were no false positives. The correlation between triple assessment and histopathological outcomes was statistically significant (p<0.001). Conclusion:Our study demonstrates that triple assessment remains a reliable diagnostic algorithm for breast lumps, closely mirroring definitive histopathology results. While histopathology is the gold standard, the high concordance underscores triple assessment s value in prompt clinical decision-making, particularly in resource limited settings.