The Diagnostic accuracy of modified triple assessment in early detection of breast carcinoma and comparative evaluation of fine needle aspiration cytology and core needle biopsy: A prospective observational study

Background: Breast cancer is a major cause of cancer morbidity and mortality. Accurate evaluation of a palpable breast lump requires integration of clinical examination, imaging and tissue diagnosis. Aims and Objectives: The aim of the study was to evaluate the diagnostic accuracy of Modified Triple Assessment (MTA) in women presenting with palpable breast lumps and to compare the diagnostic performance of fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB). Materials and Methods: Forty consecutive women with palpable breast lumps underwent clinical examination, ultrasonography, palpation-guided FNAC and CNB before definitive surgery. Histopathological examination was the standard reference. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were calculated. Results: Histopathology showed 30 (75.0%) malignant and 10 (25.0%) benign lesions. FNAC had 86.7% sensitivity, 100% specificity, 100% PPV, 71.4% NPV and 90.0% accuracy. CNB had 96.7% sensitivity, 100% specificity, 100% PPV, 90.9% NPV and 97.5% accuracy. MTA showed 100% sensitivity, 90.0% specificity, 96.8% PPV, 100% NPV and 97.5% accuracy. Conclusion: CNB showed higher sensitivity and diagnostic accuracy than FNAC in this study. FNAC remains useful as a rapid and economical initial investigation, whereas CNB provides more comprehensive tissue information for diagnostic confirmation. MTA demonstrated high overall diagnostic performance, although its composite estimate should be interpreted cautiously because tissue assessment forms part of the composite strategy.