Evaluation of Triple Assessment

Background: Clinicians remain divided on the significance and the management of patients presenting with pathological nipple discharge and on the utility of triple assessment (clinical examination breast imaging and nipple discharge cytology). Objectives: To determine the sensitivity and specificity of triple assessment in the diagnosis of breast pathology in patients with pathological nipple discharge. Design: Analytic cross-sectional study. Study setting: The Kenyatta National Hospital breast clinic. Methods: Fifty six patients with nipple discharge were prospectively reviewed between April 2012 and March 2013. The sensitivity specificity negative predicitive value (NPV) and positive predictive values (PPV) of triple assessment in defining benign and malignant lesions were calculated. Conclusion: there is no singular completely reliable method of examination. A significant risk of carcinoma exists particularly with bloody nipple discharge and surgery should still be offered as part of the management.