Triple Assessment

Question 1

What is the breast triple assessment?

Answer 1

A ‘one stop’ hospital clinic assessing 2 week wait Pts and those picked up on screening mammograms.

Question 2

How is a triple assessment scored?

Answer 2

1-5, with 1 being normal tissue and 5 being a confirmed malignancy.

Question 3

What does a score of 1 mean?

Answer 3

Normal tissue/finding

Question 4

What does a score of 2 mean?

Answer 4

Certain benign

Question 5

What does a score of 3 mean?

Answer 5

Likely benign

Question 6

What does a score of 4 mean?

Answer 6

Likely malignant

Question 7

What does a score of 5 mean?

Answer 7

Certain malignant

Question 8

What are the three aspects of the triple assessment?

Answer 8

• History and examination
• Imaging
• Biopsy

Question 9

What are the important aspects of history and examination?

Answer 9

• Age
• Risk factors
• Medication history
• Family history
• Breast and nodes examination

Question 10

What imaging is available?

Answer 10

• USS

- Mammogram

Question 11

Who gets a mammogram?

Answer 11

Women 35yo+

Question 12

What ages is mammogram screening available to?

Answer 12

Women 50-70 every three years

Question 13

Who gets an USS?

Answer 13

• Women under 35
• Men
• USS is used to guide core biopsies

Question 14

What histology is available?

Answer 14

• Core biopsy

- Fine needle aspiration

Question 15

What is the difference between FNA and core biopsy?

Answer 15

• Core biopsy provides full histology, allowing differentiation between in-situ and invasive
• FNA provides cytology only, and cannot differentiate this

Question 16

Name a therapeutic use of FNA.

Answer 16

In women with recurrent cystic disease, this can be aspirated using FNA for symptom relief and cytology.

Question 17

What happens if a patient has a grade of 4 or 5?

Answer 17

• Referral to MDT for discussion

- Majority will go on to have surgery (WLE) with chemo and/or radiotherapy if appropriate