Breast pain

For many breast problems, especially in younger patients or patients presenting with mastalgia only, reassurance and a period of watchful waiting may be suitable.

Breast pain is not usually associated with malignancy. It is a common symptom and, if of short duration with no other clinical concern, may be managed initially in a primary care setting. Studies show that breast pain often settles with 3-6 months.

Minor or moderate degree of breast pain with no discrete palpable abnormality, when initial treatment fails and/or with unexplained persistent symptoms need to be referred as non-urgent.

Cyclical breast pain in the younger patient does not need to be referred and can be managed supportively.

Assessment

Signs and Symptoms

  • Minor or moderate degree of breast pain with no discrete palpable abnormality, when initial treatment fails and/or with unexplained persistent symptoms need to be referred as non-urgent
  • Cyclical breast pain in the younger patient does not need to be referred and can be managed supportively

Investigations

Investigations in patients presenting with symptoms and/or signs suggestive of breast cancer prior to referral is not recommended.

Management

  • Management in primary care should include:
    • Reassurance
    • Advice on supportive, fitted bras
    • Oral or topical analgesia
    • Review of any hormonal medications the patient may be taking
    • Breast pain alone is not an indication for imaging
  • Minor or moderate degree of breast pain with no discrete palpable abnormality, when initial treatment fails and/or with other symptoms need to be referred as non-urgent
  • Cyclical breast pain in the younger patient does not need to be referred and can be managed supportively

Referral

Referral Criteria

  • Refer as non-urgent patients with minor or moderate degree of breast pain with no discrete palpable abnormality, when initial treatment fails and/or with unexplained persistent symptoms

Referral Instructions

  • Use e-Referrals to book the appointment, if no appointment available, click "defer to provider"
    • Priority: 2WW
    • Service: Surgery - Breast
    • Clinic type: Other symptomatic Breast
    • Service: Breast Pain-(Cancer NOT suspected)-TSDFT-Torbay-RA9

Referral Forms

DRSS referral form

Torbay and South Devon seeking advice form

Supporting Information

This guideline has been signed off by Devon CCG.

Publication date: September 2019

 

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