Triple Assessment

Triple Assessment is a patient assessment done at breast clinic.

Any patient having breast symptoms like pain, lump or any unusual findings should get an assessment by breast surgeon.

1) Clinical Assessment: First part of triple assessment is clinical assessment done by an experienced breast surgeon.

  1. History: Your doctor asks you about history of breast related symptoms like pain, lump, bloody nipple discharge, recent change in shape of nipple or breast like inverted (inward) nipples, wound/ ulcer. Also History of risk factors for breast cancer is asked like; history of any first degree relative with breast cancer, Breast feeding (protective role), age of menses start, menopause age, any history of use of contraceptive pills, dietary preferences like fatty meals, fast foods, processed meals, physical activity.
  2. Examination: An experienced breast surgeon examines your
    both breasts and armpits, nodularity, Nipple discharge to clinically find if the lump is benign looking or there is suspicious of breast cancer.

2)  Radiological Assessment: After clinical assessment next step is radiological assessment, your breast surgeon will refer you to a radiologist having special experience and interest of breast imaging. If your age is less than 35 year breast ultrasound will be done, while if you are above 35 years mammography will be done.

These imaging investigations in experienced hands can detect any abnormal or suspicious (cancerous) lump even if missed on clinical examination.

3) Histopathology/ Biopsy: 3rd step of triple assessment is biopsy of breast lump/ulcer to reach a definite diagnosis. This is gold standard for the diagnosis and confirmation of lump, whether benign or malignant.

Biopsy can be done with a;

  • Fine needle (Fine Needle aspiration cytology), FNAC
  • Tru-cut biopsy (done with a bigger needle under local anesthesia)
  • Incisional biopsy: if other smaller biopsy techniques fail to yield results suspected clinically or radiologically. This is a small surgery in which a piece og tissue is taken from lump or an ulcer under local or general anesthesia as a day care surgery.

Following triple assessment, a definite diagnosis is made and your breast surgeon will advise you surgery or non surgical treatment according to your case.