{"id":2507,"date":"2021-02-05T14:21:47","date_gmt":"2021-02-05T14:21:47","guid":{"rendered":"https:\/\/ashrafelzayat.com\/?p=2507"},"modified":"2021-11-29T11:55:13","modified_gmt":"2021-11-29T11:55:13","slug":"triple-assessment","status":"publish","type":"post","link":"https:\/\/ashrafelzayat.com\/en\/triple-assessment\/","title":{"rendered":"Triple Assessment"},"content":{"rendered":"

Triple Assessment<\/strong><\/span><\/h2>\n

Diagnosis has to be as follows:<\/strong><\/span><\/p>\n

1- Clinical examination by a specialist.<\/span>
\n2- Mammography and\/or Ultrasound examination.<\/span>
\n3- A special needle sample taken and send for microscopic examination. Fine needle is inferior with low reliability.<\/span><\/p>\n

1- Clinical examination by a specialist:<\/span><\/strong>
\nIs really needed as 15% of malignant tumors might not show on<\/span>
\nmammograms hence, examination is necessary.<\/span><\/p>\n

2- Mammography:<\/span><\/strong>
\nIs suitable for ladies over the age of 35, but not so under 35 as in the<\/span>
\nyoung, the breasts are too dense for mammogram reading<\/span>.<\/p>\n

3- Ultrasound (sonar):<\/span><\/strong>
\nSuits well those under 35.<\/span>
\nComplements Mammography, if there is an abnormality.<\/span>
\nCould well differentiate between a solid and fluid filled lesion (cyst).<\/span><\/p>\n

4- Histology Examination (Biopsy):<\/span><\/strong><\/p>\n

\u00a0A special needle biopsy (core biopsy under local anaesthesia) is<\/span>
\nmandatory.<\/span>
\nHistology \u2013 Estrogen and Progesteron and Her2 receptors. (Er,Pr,Her2)<\/span>
\nFine needle sample carries unacceptably high false negative rates and<\/span>
\ncannot differentiate between various types of tumors.<\/span><\/p>\n

Surgical excision should be prohibited (without a prior needle biopsy)<\/span>
\nand refused (accepted in very rare cases).<\/span>
\nSurgical biopsy deprives the patient of the optimal management plan,<\/span>
\nshould be refused<\/span>.<\/p>\n

5- Magnetic Resonance imaging \u2013 MRI:<\/strong><\/span><\/p>\n

Is needed is special situations, for example:<\/span>
\na) Still diagnostic uncertainty\/ discrepancy between clinical and<\/span>
\nradiological assessment.<\/span>
\nb) If actual extent of the disease cannot be properly assessed<\/span>
\notherwise – ?multiple masses \u2013 the very young.<\/span>
\nc) Screening the very young with family history of the disease.<\/span>
\nd) Invasive Lobular Cancer and the patient is keen on preserving<\/span>
\nthe Breast.<\/span>
\ne) Paget`s disease 9if the patient is keen on breast preservation.<\/span>
\nf) The very dense breast.<\/span>
\ng) Suspected implant leak<\/span><\/p>\n

6- PET mammo:<\/span><\/strong><\/p>\n

is a very new technique with very promising<\/span>
\nresults and capable of diagnosing tumours as small as 1.6<\/span>
\nmillimeters.<\/span><\/p>\n

7- CT Scan:<\/span><\/strong><\/p>\n

Is not needed in making the initial diagnosis but, might be needed after<\/span>
\ndiagnosis in planning the best management, :<\/span>
\nI. Tumors larger than 5cm (T3)<\/span>
\nII. Fixed tumors. (T4)<\/span>
\nIII. More than 3 Lymph Nodes involved.<\/span>
\nIV. Inflammatory cancer.<\/span><\/p>\n

V. Abnormal Liver function.<\/span>
\nVI. High risk on final histology report.<\/span><\/p>\n

No Surgical definitive surgery should be allowed without prior, full assessment.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Triple Assessment Diagnosis has to be as follows: 1- Clinical examination by a specialist. 2- Mammography and\/or Ultrasound examination. 3- A special needle sample taken and send for microscopic examination. Fine needle is inferior with low reliability. 1- Clinical examination by a specialist: Is really needed as 15% of malignant tumors might not show on […]<\/p>\n","protected":false},"author":11,"featured_media":1942,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[10],"tags":[],"class_list":["post-2507","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-benign-breast-tumors"],"acf":[],"jetpack_featured_media_url":"https:\/\/ashrafelzayat.com\/wp-content\/uploads\/2021\/01\/woman-checking-her-breast-for-early-signs-of-cancer.jpg","_links":{"self":[{"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/posts\/2507","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/comments?post=2507"}],"version-history":[{"count":0,"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/posts\/2507\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/media\/1942"}],"wp:attachment":[{"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/media?parent=2507"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/categories?post=2507"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ashrafelzayat.com\/en\/wp-json\/wp\/v2\/tags?post=2507"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}