Aim: To study the accuracy of Clinical Examination, Ultrasonography, Cytology Parameters in the diagnosis of palpable breast lump.

Material and Methods: 81 female patients who presented with palpable breast lump who had undergone clinical breast examination , FNAC and HR-USG of breast lump and subsequent excision biopsy were included in the study. Excision biopsy was considered as a mandatory part of the workup for patients with palpable breast lump. Initially patient was subjected for clinical breast examination which included detailed history, Inspection, Palpation of breast and systemic examination. Then patient was subjected to Ultrasonography. Interpretation of sonography was performed prospectively as benign, suspicious or malignant. FNAC was done after imaging studies, the result of the palpation-guided FNAC was analysed by pathologist and reported as benign, suspicious or malignant. Following this workup, all patients underwent an excisional biopsy. The final histopathological diagnosis was compared with the result obtained by Clinical Breast Examination, Ultrasonography, and Fine Needle Aspiration Cytology examination.

Resulits: Clinical breast examination had sensitivity of 87.09%; specificity of 90.20%; positive predictive value of 84.37%; negative predictive value of 92% and accuracy of 89.02%. Ultrasonography had sensitivity of 80.65%; specificity of 94.23%; positive predictive value of 89.3%; negative predictive value of 89.1% and accuracy of 89.16%. Fine needle aspiration cytology had sensitivity of 86.21%; specificity of 100%; positive predictive value of 100%; negative predictive value of 92.9% and accuracy of 95.06%. The triad of Clinical breast examination, Ultrasonography and fine needle aspiration cytology (modified triple test) had sensitivity of 95.65%; specificity of 100%; positive predictive value of 100%; negative predictive value of 97.87% and accuracy of 98.55%.

Conclusions: We conclude that the combined triad of clinical breast examination, Ultrasonography and fine-needle aspiration cytology was highly accurate in the diagnosis of breast lumps. 

Keywords: PPV-Positive Predictive Value; NPVNegative Predictive Value; CBE-Clinical Breast Examination; FNAC - Fine-needle Aspiration Cytology; USG- Ultrasonography; Breast Lump.