top of page

Triple Assessment of a Breast Lump

The triple assessment includes Clinical, Imaging, Histology.


Imaging:

  • Mammography - Used in older pts (35+ years) - Identifies microcalcifications and more dense tissue

  • USS - Used in younger pts (< 35 years) as their breast tissue is too dense for a mammography - Identifies solid, cystic lesions

Mammography in process: Shown is a drawing of a female having a mammogram. A mammogram is a picture of the breast that is made by using low-dose x-rays. - Alan Hoofring (https://commons.wikimedia.org/wiki/File:MammographyinprocessGraphic.jpg) “Modified version of File:Mammo_breast_cancer.jpg with arrows pointing to breast Ca” © Bakerstmd CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/)

Histology - Done by Fine Needle Aspiration (FNA) or Core Biopsy. The numbering system - FNA is ‘C’, Biopsy is ‘B’:

  • C1/B1 - Inadequate or not diagnostic

  • C2/B2 - Benign breast disease

  • C3/B3 - Ambiguous, points more to Benign

  • C4/B4 - Ambiguous, points more to Malignant

  • C5/B5 - Malignant


Breast lumps are most likely to be a Fibroadenoma or Fibrocystic change in younger women, or Breast cancer in older women.


When to refer:

  • 30+ years w/new unexplained breast lump = Urgent referral

  • < 30 years w/new unexplained breast lump = Routine referral




bottom of page