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Breast Lumps

Breast Lumps / Nipple symptoms


Require referral

·         Any new palpable breast lump which is suspicious of breast cancer

·         Any lump associated with nipple or skin changes

·         Any new skin dimple

·         Skin changes characteristic of peau d’orange

·         Blood stained nipple discharge

·         Nipple eczema suspicious of Paget’s disease

Nipple retraction / distortion of recent onset

 

Men

  • Unilateral firm subareolar mass plus/minus nipple changes

Breast cancer is rare in men, and usually presents aged over 50, but if you are concerned, referral is appropriate. Further information on Gynaecomastia is available here. If the patient proves to have gynaecomastia surgical treatment cannot be offered on the NHS under PCT commissioning rules

 

 

Referral not usually required on first presentation

  • Under age 35 years and no family history in whom the sole abnormality is asymmetrical nodularity that has been present for less than one complete menstrual cycle
  • Under age 35 years in whom the sole abnormality is bilaterally symmetrical nodularity
    • These should be followed-up in 4-6 weeks (mid menstrual cycle) and referred if:
      • Persisting discrete lump
      • Development of other breast symptoms:
      • Persisting asymmetric nodularity i.e. not cyclical


Do not usually require referral

  • Persistent symmetrical diffuse nodularity in females under age 35 years, unless associated with:
    • Severe persistent breast pain
    • Localised abnormalities 

All patients referred with breast symptoms are seen within 2 weeks (and often within 1 week)