Why my doc sent me to a surgeon with a mammogram with ill marginated focal asymmetry and sonogram with 2 lipomas no correlated with mammogram?

Evaluation: A trained breast surgeon will examine you and review your radiology findings. Sometimes nothing more is needed if there are only benign findings, sometimes further radiology tests are indicated & sometimes a small needle biopsy may be indicated. See what the surgeon recommends.

It sounds like: the mammogram had a concerning finding that could not be visualized on the ultrasound. The lipomas are benign, but the mammographic abnormality needs further evaluation. You should talk to your doctor, but it sounds like he/she may be contemplating biopsy for the mammo finding.

For surgical options: Breast abnormalities can be found on exam, on MMG, or by US. Depending on what the abnormality is, each may find something different. PE, MMG, and US are different modalities that can detect various problems. Use of all three is a more thorough way to see into the breast tissue. The surgeon will determine if any surgery is needed to remove any of the abnormalities found.