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Only about half of diagnosed breast cancers were coming through the urgent 2ww route so in January 2010 the 2ww standard was expanded so that any patient referred with breast symptoms would be seen within 2 weeks, whether cancer was suspected or not.
There is continuing confusion about which referral route to use for patients resulting in many patients not benefiting from the faster pathways (2ww and 62 days) that could improve, not only their experience of the service, but also, potentially, their outcome.
GPs are reminded that symptomatic breast disease where cancer is not suspected may be appropriate for management in primary care.
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 within 3-6 months.
Management in primary care should include:
It should also be noted that any patient in whom presumed mastitis does not resolve after a month of treatment needs referral to exclude inflammatory breast cancer.
Review: Specialist: Julie Dunn | GP: Lucy Harris | Lynne Kilner
Published: May 2015