A 42-year-old woman presents with a painless discrete lump in the upper outer quadrant. Fine needle aspiration cytology shows C3 (probably benign) result and imaging is BI-RADS 4A. Which statement best describes the appropriate management according to the 'triple assessment' principle?
- A Core needle biopsy is required as C3/BI-RADS 4A discordance mandates tissue diagnosis ✓
- B Reassurance and discharge as all three assessments are non-malignant
- C Proceed to open surgical excision biopsy
- D Repeat triple assessment in 6 months
Correct answer: A. Core needle biopsy is required as C3/BI-RADS 4A discordance mandates tissue diagnosis
Explanation
Triple assessment comprises clinical examination, imaging (mammography/ultrasound), and cytology/histology. A C3 FNAC result (probably benign) combined with a BI-RADS 4A imaging finding (low suspicion, 2-10% malignancy risk) represents a discordant triple assessment — not all three pointing to benign. Current UK and NHSBSP guidelines require core needle biopsy (histology) for any discordant triple assessment to provide definitive tissue diagnosis before any management decision.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.