유방 종괴에 대한 변형 3중복 검사
A Study on Modified Triple Test for Palpable Breast Mass
김진권, 송영진, 조성일, 윤효영, 윤희석,
소속 상세정보
김진권 ( Kim Jin-Kwon )
Chungbuk National University
송영진 ( Song Young-Jin )
Chungbuk National University
조성일 ( Cho Sung-Il )
Chungbuk National University
윤효영 ( Yun Hyo-Yung )
Chungbuk National University
윤희석 ( Yoon Hee-Suk )
충남대학교 의과대학 마취통증의학교실
KMID : 0371320010610010027
Abstract
Purpose
The ’triple test’ (TT) which consists of a physical examination (PE), mammography (MMG), and fine needle aspiration (FNA) has been used for diagnosing a palpable breast mass. However, the TT is not always accurate when it is applied to young
women.
This
is because a dense breast hampers the sensitivity of a mammograph. Here, we introduce breast ultrasonography (USG) in place of a MMG (Modified TT; MTT) to determine whether this method can facilitate a correct diagnosis of a breast mass.
Methods
A MTT was performed in 142 palpable solid breast masses from 126 female patients between August 1998 and July 2000 at the out-patient breast clinic, Chungbuk National University Hospital. The breast masses were listed as benign or
suspicious/malignant.
All patients underwent a subsequent needle biopsy or surgical biopsy for a definitive diagnosis.
Results
78 out of 142 palpable breast masses (54.5%) were benign, while 64 (45.5%) were diagnosed as having
breast cancer. In all 105 cases (73.9%) where the MTT was concordant (elements had either all malignant or benign results), a needle or surgical biopsy was confirmatory (predictive values, sensitivity, and specificity 100%). In 37 cases of the
non-concordant results, 16 (44.7%) were proven as malignant. The positive predictive value for PE, USG, and FNA was 80.6%, 87.1%, and 100% respectively. The negative predictive value for PE, USG, and FNA was 91.4%, 95.8%, and 91.8% respectively.
The
sensitivity for PE, USG,and FNA was 90.6%, 95.3%, and 89.1% respectively. The specificity for PE, USG, and FNA was 82.1%, 88.5%, and 100% respectively.
Conclusion
The modified triple test was 100% accurate for diagnosing a palpable breast mass when all three elements were concordant. A palpable breast mass with a concordant benign modified triple test could be safely followed up without a surgical biopsy,
and a
final treatment could be applied to patients who have had a concordant malignant modified triple test.
키워드
유방 종괴; 이학적검사; 초음파검사; 세포 검사; 변형 삼중복 검사; Breast mass; Physical examination; Ultrasonography; Cytology; Modified triple test;
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