What is triple assessment of a breast lump?

Triple assessment is the standard evaluation of a breast lump, combining three components:

1. Clinical assessment - history and examination
2. Imaging - mammography and/or ultrasound
3. Pathology (cytology/histology) - fine needle aspiration cytology (FNAC) or core biopsy

Using all three together gives the highest diagnostic accuracy and reduces missed cancers.

Clinical relevance. Triple assessment is the standard, highest-accuracy approach to a breast lump, minimising missed cancers.

More Detail

Triple assessment

Triple assessment is the cornerstone of evaluating a breast lump.

The three components

1. Clinical assessment - history (risk factors) and examination (inspection and palpation).
2. Imaging - mammography (older women) and/or ultrasound (younger women, to complement mammography).
3. Pathology - fine needle aspiration cytology (FNAC) or core biopsy for cytological/histological diagnosis.

Why all three

• Each modality can miss disease alone; combining all three maximises sensitivity and specificity and reduces missed cancers.
• Concordant 'benign' results across all three are reassuring; any discordance (e.g. benign imaging but suspicious clinically) prompts further evaluation.

Use

• Applied to any discrete breast lump or suspicious symptom, ideally in a one-stop breast clinic.