How confident can we be about the outcome from a triple assessment for a breast lump?

Mr. Mukherjee, when you do your triple assessment, how do you manage the degree of sort of uncertainty and ambiguity from the results? So we discuss them at the MDT where you need to, we make sure that the examination, the physical examination, the imaging which is mammogram or ultrasound scan and the histology, all the triple assessment actually go in one direction confirming that this is a benign lesion. If there's any doubt, if there's any suspicion or unanswered question and the MDT decisions will be made whether to take more sample or on some occasions to go and take the lump out completely to make sure that this is benign. So no chances are taken after the triple assessments. Do you have a grading system in your assessment tools that you have? Yes we do there is an internationally agreed assessment we the number is one to five so we use that but for physical examination for mammogram ultrasound and the histology one means that it's completely benign normal two means there's something there but nothing to worry about three where it's indeterminate for there is a suspicious lesion either on mammogram ultrasound can all under biopsy and five where it suggests that this is cancer so the decisions these are all brought in together to make the right decision and if on any particular patient even if the clinical examination suggests this is benign but the mammogram suggests that this is 4 or 5 then the highest rating is considered and all other investigations are requested additional investigation to make sure so that we can confidently determine exactly what it is. Thank you.