Flowchart to aid decision making about breast symptoms. 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
