Your GP should arrange for you to go to a breast clinic to have tests if you have symptoms that could be due to breast cancer. Depending on your symptoms and other factors, this might be an urgent referral.
Or you might have a referral to the breast clinic following a positive result from your breast screening mammogram.
You will see a breast specialist at the breast clinic as soon as possible. Ask your GP when this is likely to be.
Seeing your GP
It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.
Your GP might arrange for you to have an appointment at a breast clinic. This is usually a one stop clinic where you have several tests during one visit. It is also called a triple assessment.
The tests you have can diagnose breast cancer and other breast conditions. These tests you might have include:
- breast examination
- breast ultrasound scan
- a breast biopsy
On average, GPs see about 1 to 2 women a year who have breast cancer. But they will see a lot more women who have non cancerous (benign) breast conditions such as:
- cysts – sacs of fluid in the breast tissue (most common in women between 35 to 50 years)
- fibroadenomas – collections of fibrous glandular tissue (most common in women aged between 15 to 35)
- diffuse nodularity (lumpy breasts) – this is more common in women younger than 50
- breast pain – this is not a usual symptom of breast cancer
The risk of getting breast cancer gets higher as you get older. More breast cancers are diagnosed in women over 50 and it is less common in women under 40.
Around 4 out of 100 women (around 4%) are called back for more tests after breast screening. This might be a referral to a breast clinic. If this happens, you might feel very worried. But many of these women won’t have cancer.
UK referral guidelines
There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.
In England, Wales and Northern Ireland
Your GP should offer you an appointment at a breast clinic urgently if you:
- are 50 or over and have a change to a nipple, such as discharge or a nipple appearing to be pulled inwards
- are 30 or over and have a lump in your breast or under your armpit, with or without pain, that isn't caused by anything else
- have changes to the skin of your breast, such as puckering or dimpling
- have other changes that are possible signs of breast cancer
If you are under 30 and have a lump in your breast that isn't caused by anything else, your GP might offer you an appointment to a breast clinic. But this may not be an urgent referral. Your GP may get advice from the breast clinic about whether to refer you.
Your doctor should offer you an urgent referral to a breast clinic if you:
- are over 30 and have a new breast lump
- have a swollen
lymph nodein your armpit that doesn’t go away after 2 or 3 weeks
- are over 35 and have lumpiness in your breast that doesn't go away after 2 or 3 weeks
- have a cyst in your breast that keeps coming back
- have nipple changes such as pulling inward, a bloodstained discharge, or a rash that looks like eczema and doesn't get better after treatment with steroids
- have skin changes, such as tightening, pulling inwards, redness and soreness, or looking like orange peel
- inflammation of the breast that doesn't respond to antibiotics or comes back after taking antibiotics
Your GP might offer you an appointment to a breast clinic as a routine appointment (rather than an urgent appointment) if you have any of the following:
- a lump in your breast that isn't caused by anything else and you are under 30
- lumpiness in your breast that doesn't go away after 2 or 3 weeks and you are under 35
- a persistent discharge from your nipple that is enough to stain your outer clothes
- breast pain lasting for over 3 months and you are
- severe breast pain that is affecting your daily life or sleep at night
Remember, these symptoms can be caused by other conditions, and do not necessarily mean that you have breast cancer. But it is important to get them checked out.
Your GP will consider any other symptoms that you are having, so do mention these. They might also take into account whether you have any risk factors that affect your chances of developing breast cancer.
If you are worried
Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print or show them this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral.
Contact your GP again if your symptoms don't get better or you notice any new or unusual symptoms.
What should I do if I don’t get my appointment?
If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral.
Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.