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Referral to a specialist

Find out when GPs refer people to see a breast cancer specialist.

Your GP should arrange for you to see a specialist within 2 weeks if you have symptoms that could be due to breast cancer. This is called an urgent referral.

Seeing your GP

A GP with 2,000 patients is likely to see only one woman a year who has breast cancer. But they will see a lot more women who have non cancerous breast conditions such as:

  • cysts – sacs of fluid in the breast tissue (most common in women between 40 to 60 years)
  • fibroadenomas – collections of fibrous glandular tissue (most common in women aged between 20 to 30)
  • diffuse nodularity (lumpy breasts) – this is common in all age groups up to 50
  • breast pain – this is not a usual symptom of breast cancer

It can be hard for GPs to decide who might have cancer and who might have a more minor condition. 

There are national guidelines in the UK that advise GPs about which symptoms mean you should see a specialist within 2 weeks.

Urgent referral

According to the guidelines, your GP should make an urgent referral if you are aged 30 or more and have an unexplained lump in your breast with or without pain.

They should also refer you if you are aged 50 or over and have:

  • changes to one of your nipples such as discharge
  • the nipple appears to be pulled inwards (retracted)
  • other changes of concern such as puckering or dimpling of the skin

Possible urgent referral

Your GP should consider referring you to a specialist if you:

  • have skin changes such as a lump, puckering or dimpling that suggest you could have breast cancer
  • are aged 30 or over and have an unexplained lump in your armpit (axilla)

Non urgent referral

Your GP should consider a non urgent referral if you are 30 or younger with an unexplained lump in your breast (with or without pain).

A non urgent referral means you should see a specialist within about 6 weeks. 

It is important to remember that these symptoms may be due to conditions other than breast cancer.

Symptoms that are unlikely to be cancer

There are certain sets of symptoms that are very unlikely to be cancer, such as:

  • young women who have tender, lumpy breasts
  • older women with breasts that are similarly lumpy on both sides
  • minor or moderate breast pain with no lump

It is very common for women to have tender, lumpy breasts in their 20s, 30s and 40s. The lumpiness is most common before a period. If your breasts are equally lumpy on both sides and the lumps come and go, this isn't likely to be cancer.

The risk of getting breast cancer gets higher as you get older. Only 4 out of every 100 women (4%) diagnosed with breast cancer are under 40. Only 2 out of every 100 breast cancers (2%) are diagnosed in women under 35.

If you are worried

If you have a symptom listed here as urgent and you are worried that your GP isn't taking it seriously, you could print this page and take it to an appointment.

Ask your GP to talk it through with you. Then you may be able to decide together whether you need to see a specialist and if so, how soon.

UK referral guidelines

The National Institute for Health and Care Excellence (NICE) and Healthcare Improvement Scotland (HIS) produce guidelines for GPs.

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.