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Related Experiment Videos

Assessment of breast problems.

I S Fentiman1, H Hamed

  • 1Hedley Atkins Breast Unit, Guy's Hospital, London SE1 9RT, UK.

International Journal of Clinical Practice
|October 12, 2001
PubMed
Summary
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Women with discrete breast lumps require assessment. Most breast pain, blood-containing nipple discharge without a lump, and family history concerns do not necessitate referral, but screening attendance is encouraged.

Area of Science:

  • Oncology
  • Radiology
  • General Practice

Background:

  • Timely referral for breast conditions is crucial for early diagnosis and management.
  • Guidelines for referral can vary, leading to potential over or under-utilization of breast clinic resources.
  • Accurate assessment of breast symptoms impacts patient anxiety and healthcare costs.

Purpose of the Study:

  • To delineate clear referral criteria for common breast symptoms in women.
  • To reduce unnecessary referrals for benign breast conditions.
  • To ensure appropriate and timely assessment for potentially malignant breast conditions.

Main Methods:

  • Review of current clinical guidelines and evidence for breast symptom referral.
  • Analysis of patient demographics and symptom presentation in relation to diagnostic outcomes.

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  • Development of a decision-making framework for primary care physicians.

    • Main Results:

    • Discrete breast lumps warrant referral regardless of age.
    • Premenopausal women with equivocal lumps may benefit from a short-term re-evaluation.
    • Most cases of breast pain, and blood-containing nipple discharge without a palpable lump, do not require referral.
    • Family history of breast cancer alone is often insufficient for referral without other concerning signs.
    • Women eligible for the National Health Service (NHS) breast screening program should be encouraged to attend.

    Conclusions:

    • Referral criteria for breast lumps should be age-independent.
    • A nuanced approach is needed for equivocal lumps and specific symptoms like nipple discharge.
    • Reassurance and symptomatic management are appropriate for many benign breast conditions, reducing unnecessary referrals.
    • Encouraging participation in breast screening programs remains a key strategy for early detection.