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Referral
Breast Symptoms
Key Messages
This guidance covers the referral of a patient who presents with symptoms suggestive of breast cancer to a team specialising in the management of breast cancer.
- GPs can refer a patient they suspect of having cancer to be seen by a specialist. GPs must send the referral within 24 hours of the decision to refer.
- Please use the referral forms listed on this page to ensure appropriateness. They have been agreed by the Peninsula Cancer Network.
Investigations in patients presenting with symptoms and/or signs suggestive of breast cancer, investigation prior to referral is not recommended.
In general:
- convey optimism about the effectiveness of breast cancer treatments and survival of breast cancer patients
- discuss the information and support needs of your patient and respond sensitively
- encourage all patients, including women over 50 years old, to be breast aware.
Always take the patient’s history into account. For example, it may be appropriate, in discussion with a specialist, to agree referral within a few days in a patient who reports a lump or other symptom that has been present for several months.
Referral Criteria
Suspected Cancer referral
Aged 30 and over with an unexplained breast lump
Aged 50 and over with any of the following symptoms in one nipple only
- Discharge (spontaneous clear or bloody)
- Retraction
- Skin changes of concern
Consider Suspected Cancer referral
Aged over 30 with unexplained lump in the axilla and have skin changes that suggest breast cancer
A non-urgent referral should be considered in:
- women aged younger than 30 years with a lump
- Any women with breast pain only, the GP should write a referral to the Breast Pain Clinic (see attached flowchart)
Referral instructions
The GP should: use e-Referral Service to book an appointment or send the referral.
Please ensure you include:
- The patient's NHS number
- Tell the patient that this is an urgent referral and they will be seen usually within 2 weeks
Specialty: 2WW
- Clinic type: 2WW Breast
- Service: 2WW-Breast Surgery-TSDFT-Torbay-RA9
For any patients that you are unable to process through NHS e-Referral please contact the drss.helpdesk@nhs.net.
Suspected cancer referral
Priority: 2WW
Service: 2WW
- Clinic type: 2WW Breast
- Service: / 2WW-Breast Surgery-TSDFT-Torbay-RA9
Cancer not suspected referral
e-Referral selection: T&SD
Service: Surgery - Breast
- Clinic type: Other symptomatic Breast
- Service: Symptomatic Breast (cancer not suspected) – RA9
Service: Surgery - Breast
- Clinic type: Breast Pain
- Service: Breast Pain – RA9
(Please note this is an initial advice & guidance service – no face to face appointments will be offered in the first instance – see Breast Pain flowchart)
Referral Forms
Suspected Breast Cancer referral form - No merge fields
Evidence
NICE referral guidelines for suspected cancer
GP Information
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
Patient Information
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
Pathway Group
This guideline has been signed off by NHS Devon.
Publication date: April 2024
