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Referral Guidelines for Breast Disorders

Adapted from: NHS Cancer Screening Programmes: Guidelines for referral of patients with breast problems (2nd ed). 2003.

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REFERRAL CHECKLIST
  • Lump
    – Any new discrete lump
    – Any new lump in pre-existing nodularity
    – Asymmetrical nodularity that persists at review after menstruation
    – Abscess
    – Persistent or recurrent cysts
  • Pain
    – If associated with a lump
    – Intractable pain not responding to reassurance, simple measures such as wearing a well-supporting bra, and common drugs
    – Unilateral persistent pain in postmenopausal women
  • Nipple discharge
    – Women under 50 with:
       - bilateral discharge sufficient to stain clothes
       - bloodstained discharge
    – All women aged 50 and over
  • Nipple retraction, distortion or eczema
  • Change in skin contour
  • Family history
    Request for assessment by woman with strong family history
Note: The classification 'urgent' should be reserved for those patients with symptoms highly suggestive of breast cancer: a discrete lump in the appropriate age group; definite signs of cancer such as ulceration, skin nodule, skin distortion.

Full NHS Cancer Screening Programmes guideline

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