Diagnosis of Palpable Breast Lesions in Younger Women by the Modified Triple Test Is Accurate and Cost-effective
| Autor: | Heidi Eppich, Priscilla W. Alexander, Waldemar A. Schmidt, John T. Vetto, Rodney F. Pommier |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
medicine.medical_specialty Open biopsy Cost-Benefit Analysis Breast Neoplasms Physical examination Breast cysts Lesion Breast Diseases Biopsy Humans Medicine Mammography Palpation medicine.diagnostic_test business.industry Biopsy Needle Triple test Reproducibility of Results medicine.disease Predictive value Surgery Female medicine.symptom business Follow-Up Studies |
| Zdroj: | Archives of Surgery. 131:967 |
| ISSN: | 0004-0010 |
| DOI: | 10.1001/archsurg.1996.01430210065012 |
| Popis: | Objective: To study the accuracy and cost of diagnosing palpable breast lesions in younger patients using a modified triple test (MTT: physical examination, ultrasonography instead of mammography, and fine-needle aspiration). Design: Diagnostic test study and cost-effectiveness estimate. Setting: Multidisciplinary university breast clinic. Patients: Fifty-five women below the recommended age of screening mammography (mean age, 33 years) with unilateral, palpable breast lesions. Intervention: Each lesion was tested by all 3 elements of MTT, and each element was interpreted as benign, suspicious, or malignant. Main Outcome Measures: Patients with MTTs in which all elements were concordant (in agreement) and benign were evaluated clinically (mean follow-up, 11 months). Patients in whom the results of fine-needle aspiration were scored as suspicious or malignant underwent open confirmatory biopsy. Results: Forty-eight patients had concordant benign MTTs, including 14 patients with breast cysts. No cancers developed at the index sites during follow-up, including 5 biopsies done at the patients' request (negative predictive value and specificity, 100%). Fine-needle aspiration and physical examination were more accurate than ultrasonography in the 7 cases in which MTT was nonconcordant. Compared with the criterion standard (physical examination and open biopsy), use of MTT under the conditions of this study could avoid open biopsies in almost all cases, with average savings in charges of up to $623 per case. Conclusion: Use of MTT for the diagnosis of unilateral, palpable breast lesions in younger women yields high diagnostic accuracy without the need for routine open biopsy, resulting in an overall reduction in patient charges. Arch Surg. 1996;131:967-974 |
| Databáze: | OpenAIRE |
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