Evidence relevant to the investigation of breast symptoms: the triple test

This paper reviews and summarises evidence on the investigation of breast symptoms based on triple testing. The triple test (where any component is positive) has a sensitivity of 99.6%, a specificity of 62%, a likelihood ratio of 2.62 for a positive result, and a likelihood ratio of 0.006 for a negative result. We present measures of test accuracy for the components of the triple test that allow easy estimation of the probability of breast cancer in symptomatic women, given any possible combination of results.