Triple Assessment

Question 1

What is the triple assessment?

Answer 1

Hospital-based assessment clinic that allows for early and rapid detection of breast cancer - where GP 2ww referrals go

1. Clinical examination
2. Imaging
3. Tissue sampling

Question 2

Which imaging modalities are used in triple assessment?

Answer 2

Mammography

USS - more useful for women <35 yrs and men - used for core biopsy as well

MRI not mainstay but can be used in lobular Breast cancers

Question 3

What is the difference between a core biopsy and fine needle aspiration?

Answer 3

Core biposy - provides full histology an can be used grade + stage cancers + receptor sensitivity - GOLD standard

Fine needle aspiration - only provides cytology

Question 4

How is the suspicion of malignancy graded in triple assessment?

Answer 4

Uses imaging score and histology score

P1 - normal 
P2 - benign 
P3 - uncertain/likely benign 
P4 - suspicious of malignancy 
P5 - malignant

Question 5

What can be done if FNA and Core biopsy come back negative but there is still doubt on imaging?

Answer 5

Open biopsy