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Cancer and 2WW
Breast (Female)

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Suspected Cancer: 2 Week Wait
  • Discrete, hard lump ± fixation,  ± skin tethering
  • 30 years + with a discrete lump that persists post period / menopause
  • Spontaneous unilateral bloody nipple discharge or which stains clothes
  • Nipple retraction or distortion of recent onset (<3 months onset)
  • Skin distortion / tethering / ulceration / Peau d'orange
  • Unexplained lump in axilla
Cancer Less Likely

These symptoms are routinely managed by ERS A&G, please use this route prior to making a referral to the breast unit:

  • Women aged < 30 years with a lump
  • Patients with breast pain alone (no palpable abnormality)
    • CONSIDER PRIMARY CARE MANAGEMENT FIRST:
      See Mastalgia Pathway on Breast Pain Pathfinder
  • Asymmetrical nodularity or thickening that persists at review after menstruation
  • Infection or inflammation that fails to respond to antibiotics
  • With unilateral eczematous skin of areola or nipple:
    • CONSIDER PRIMARY CARE MANAGEMENT FIRST: 
      2 weeks topical treatment such as 0.1% mometasone
  • Unilateral, spontaneous, nipple discharge that is persistent or troublesome

Asymptomatic but concerned about family history? 

Please use the link below to see criteria for referral to FH Breast Clinic.

NICE CKS Family History of Breast Cancer

Significant Weight Loss Only?

Non Site-Specific Pathway

External Links
NICE CKS Family History of Breast Cancer