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'Referral advice' recommendation details

Recommendation details

Referral advice recommendation:The features of a lump that should make the primary healthcare professional strongly suspect cancer are a discrete, hard lump with fixation, with or without skin tethering. In patients presenting in this way an urgent referral should be made, irrespective of age. In a woman aged 30 years and older with a discrete lump that persists after her next period, or presents after menopause, an urgent referral should be made. Suspected benign lumps (for example, fibroadenoma) in women under 30 years are common and non-urgent referral should be considered. However, in women aged younger than 30 years: with a lump that enlarges, or with a lump that has other features associated with cancer (fixed and hard), or in whom there are other reasons for concern such as family history an urgent referral should be made. The patient's history should always be taken into account. For example, it may be appropriate, in discussion with a specialist, to agree referral within a few days in patients reporting a lump or other symptom that has been present for several months. In a patient who has previously had histologically confirmed breast cancer, who presents with a further lump or suspicious symptoms, an urgent referral should be made, irrespective of age. In patients presenting with unilateral eczematous skin or nipple change that does not respond to topical treatment, or with nipple distortion of recent onset, an urgent referral should be made. In patients presenting with spontaneous unilateral bloody nipple discharge, an urgent referral should be made. In a man aged 50 years and older with a unilateral, firm subareolar mass with or without nipple distortion or associated skin changes, an urgent referral should be made.
Recommendation ID:270
Referral advice category:Urgent

Source guidance details

Guidance ID:CG27
Issue date:June 2005
Paragraph number:1.6.5
Page number:23
View all NICE referral advice recommendations from this guidance:

NICE Classifications

Topic:
  • Cancer
Sub topic:
  • General practice
  • Medical oncology

Other details/links

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This page was last updated: 22 August 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.