A System of Scoring Palpable Breast Masses in Women under the Age of 40

Introduction & In women under 40 years of age, which are afflicted with palpable breast masses, the surgeon sometimes encounters situations that inspite of physical examination, mammography and fine needle aspiration, cant decide whether to perform open biopsy or not. The purpose of this study was to develop a rapid and accurate diagnostic test for palpable breast masses in women under the age of 40. Breast masses are evaluated utilizing a modified triple test score (MTTS) which assigned scores of 1 for benign, 2 for suspicious, and 3 for malignant masses from physical examination, ultra-sonography, and fine needle aspiration. The MTTS is the sum of three scores and is corrected with biopsy and follow up. Among the 100 evaluated masses, 69 scored 3, 15 scored 4; all were benign. Four scored 5; 1 was malignant. Five scored 6 and three were malignant. Seven scored 7, 8, and 9 and all were malignant. The MTTS had 100% diagnostic accuracy in cases other than those with scores 5 and 6 points. Masses scores 4 points are benign. Those having scores seven up to nine points were proceed to definitive therapy. Those having scores five and six points need evaluation. This approach dose not avoids open biopsy in the majority of cases, but while captures all malignant cases.