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.

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