Referral Guidelines

The symptoms that need urgent referral for possible cancer of the breast are:

• A fixed, hard lump in the breast at any age.
• Women aged 30 or over who have a lump that is still there after their next period.
• A women with a lump that appears after menopause.
• Women under 30 with a lump that is getting bigger, is fixed and hard or who have other particular reasons for concern, such as a strong family history of breast cancer.
• Anyone who has had breast cancer before and has another lump or other suspicious symptoms.
• A rash on one nipple or in the surrounding area (this is very rare), that has not responded to treatment.     
• Nipples that have turned in (inverted) recently.
• Blood stained or clear serous discharge from the nipple for no apparent reason.
• Men, aged 50 or over with a firm lump under one nipple, with or without changes in nipple shape or to the surrounding skin.

The symptoms that need referral, but not urgently, are:

• A distinct lump in women under 30.
• Breast pain (with no lump) that does not go away with reassurance, wearing a well supporting bra, or painkillers prescribed by your GP.

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