Referral

Appropriate referral is a key step in the assessment of the woman with breast symptoms. A General Practitioner should clinically examine patients, or a nurse practitioner trained in breast assessment, and referred in accordance with the criteria below.

Urgent Referral (considered to be cancer)

Signs & symptoms which are highly suggestive of cancer:

• Ulceration
• Skin nodule
• Skin distortion
• Nipple eczema
• Recent nipple retraction or distortion
• Unilateral nipple discharge which stains clothes
• Lump which is fixed & hard
• Aged under 30 years
• Lump that enlarges
• Lump with features associated with cancer or in whom there are other reasons for concern e.g. Family history
• Palpable discrete lump in patients aged over 30 years – persistent after period or presents after the menopause
• Men over 50 years with unilateral sub-areola mass with or without nipple distortion, or associated skin changes

Routine Referral

• Palpable discrete lump in patients aged under 30 years
• Asymmetrical nodularity that persists at review after menstruation
• Abscess
• Persistently refilling or recurrent cyst
• Nipple discharge: Bilateral sufficient to stain clothes in patients under 50 years, any nipple discharge in patients over 50
• Referrals into a diagnostic clinic should be made using the designated referral form

All urgent referrals for suspected cancer must be faxed to 01753 849200 within 24hours of decision to refer. Patients will be given an appointment within 14 days.

Rapid Access

Breast cancer patients and their relatives/carers or GP can access the service directly via the Breast Care nurses at the Parapet or the breast unit clinic office.