Warning

See also individual pages for more information on primary care management and non-cancer symptoms:

Breast Lumps

Refer urgent suspicion of cancer

  • Any new discrete lump (in patients 30 years and over)
  • New asymmetrical nodularity that persists at review after  two to three weeks (in patients over 35 years)
  • Unilateral isolated axillary lymph node in women persisting at review after two to three weeks
  • Recurrent lump at the site of a previously aspirated cyst

Routine referral

  • Any new discrete lump in patients under 35 years with no other suspicious features
  • New asymmetrical nodularity that persists at review after two to three weeks (in patients under 35 years)

For more detail on breast lumps management see here

Nipple symptoms

Refer urgent suspicion of cancer

  • Visibly bloodstained discharge
  • New unilateral nipple retraction
  • Nipple eczema if unresponsive to moderately potent topical steroids after a minimum of two weeks

Routine referral

  • Persistent unilateral spontaneous  discharge sufficient to stain outer clothes

For more information on non-cancer management see here

Skin changes

Refer urgent suspicion of cancer

  • Skin tethering
  • Fixation
  • Ulceration
  • Peau d’orange

Abscess/Infection

Refer urgent suspicion of cancer

  • Mastitis or breast inflammation which does not settle or recurs after one course of antibiotics

For information on non-cancer management of breast infection see here

Editorial Information

Last reviewed: 30/10/2023

Next review date: 30/10/2025

Author(s): Maria Bews-Hair.

Version: 1.0

Approved By: Scottish referral guidelines for suspected cancer