Healthcare Improvement Scotland have recently published updated guidelines and advice for breast disease and the referral of patients with suspected breast cancer to secondary care. A link to the document can be found below:
Scottish Referral Guidelines for Suspected Cancer
If you suspect that your patient has breast cancer you should make an "Urgent Suspected Cancer" referral otherwise refer “Routinely”.
It is important that you should only use the classification "Urgent Suspected Cancer" for those patients whose symptoms are highly suggestive of breast cancer as advised in the guidelines.
The Main Features of this group will be:
- A discrete lump
- Definite signs of cancer such as;
- skin nodule
- skin distortion or change of contour
- Inflamed breast in post-menopausal women
- Eczematous nipple
Other presentations of breast cancer are much less common. Inflammatory Cancers can present with appearances mimicking a breast abscess. However, Non cyclical Breast Pain is an exceedingly common symptom, often musculo-skeletal and referred to the breast rather than due to breast disease and does not confer any increased risk of or is it associated with a diagnosis of breast cancer in the absence of any of the features mentioned above.
Advice on the following conditions is contained in these guidelines and within the healthcare improvement Scotland national guidelines.