HNY Policy and Pathway Repository - York

Any new lump in the breast.

• Discrete lump in woman aged 30 or over.
• Associated ulceration, skin nodule, skin distortion or palpable axillary lymph nodes.
• Unilateral firm subareolar mass in men aged 50 or more.
• Associated erythema or redness of the breast tissue.
• Increase in size or change in character of a pre existing or previously investigated lump
• All require urgent referral under Two Week Rule

• Asymmetric nodularity should be reassessed after 6 weeks and referred if persistent.
• Young women <35 with long standing painful lumpy breasts and older women with symmetrical nodularity if not a localized abnormality can be managed in Primary Care with reassurance and review.
• Smoking cessation to be encouraged
• Weight loss (if appropriate) to be encouraged

Information to include in referral letter

• Site and duration of lump
• Any family history of breast or ovarian cancer
• Relevant past medical / surgical history
• Current regular medication
• BMI/ Smoking status

http://www.patient.co.uk/health/breast-lump

 

References

• NICE Referral Advice Updated 22 08 12
• CRUK Guidelines for Referral of Patients with Breast Problems
• SIGN Guideline 84: Management of Breast Cancer in Women