What is the recommended action when ultrasound and core biopsy results do not agree for a breast lump?

When ultrasound and core biopsy results do not align for a breast lump, the recommended action is to perform an excision biopsy. This approach is selected to ensure an accurate diagnosis, particularly when the imaging findings suggest a different pathology than what is indicated by the core biopsy results.

Excision biopsy involves surgically removing the entire lump or a larger tissue sample, allowing for thorough histopathological evaluation. This method provides definitive information on the nature of the lump, which is crucial in breast cancer management. It addresses the possibility of sampling error in the previous biopsy and offers a conclusive diagnosis that may change the treatment plan.

Monitoring, while it may be a consideration in some cases, does not resolve the conflicting results and could delay necessary treatment. Repeat ultrasound may not yield new information and does not address the need for a definitive tissue diagnosis. Fine needle aspiration, while minimally invasive and useful in some cases, typically provides even less tissue than core biopsy and may not be sufficient to clarify discrepancies. Therefore, excision biopsy is the most appropriate and definitive next step when faced with conflicting ultrasound and biopsy findings.