Triple Assessment in the Clinical Evaluation of Ductal Breast Disease

Breast discharge represents the third most common reason women seek medical attention for breast-related concerns. A triple assessment is recommended for additional screening in cases of suspected ductal illness if there is nipple discharge. This study aimed to evaluate the different clinical characteristics of ductal breast disease in relation to Triple Assessment (Clinical examination, Imaging, Histopathology). This cross-sectional study was conducted among 100 purposively included female patients presented with nipple discharge (ND) selected from both Outdoor and Indoor Department of Surgery, Rajshahi Medical College Hospital (RMCH), Rajshahi, Bangladesh. Data regarding clinical, biochemical and surgical profiles were recorded. Informed written consent was taken from all the patients before data collection. Data was collected from May 2019 to October 2019. In descriptive statistics, the frequency distribution was done using STATA-18. The findings of the Triple assessment were categorized as malignant and non-malignant using the chi-squared test. All statistical tests were two-tailed. A p-value of 0.05 or less than 0.05 was considered statistically significant. Age 40 years or above (p<0.001), presence of a breast lump (p<0.001), micro-calcification found in mammography (p<0.001) and suspected malignancy in ultrasonography (p<0.001), bloody nipple discharge (p<0.001) were found statistically significant in association with malignancy compared to benign lesions. Triple assessment can help to assess high-risk patients, requiring careful treatment to rule out malignancy. Patients aged 40 years or more with the presence of breast lump and bloody discharge are at high risk of cancer. The risk of underlying cancer can be precisely established by applying the methodical, gold standard approach of Triple Assessment.