Breast Cancer

DGRefHelp - NHS Dumfries & Galloway
NHS Dumfries and Galloway

See also individual pages for more information on primary care management and non-cancer symptoms:

Breast Lumps

Refer urgent suspicion of cancer

  • Any new discrete lump in patients 30 years and over
  • New breast lump in patient < 30 with axillary lump, suspicious nipple/skin changes or significant family history of breast cancer
  • New, unexplained axillary lymph node 2cm or more in size persisting at review after six weeks or increasing in size

Routine referral

  • Any new discrete lump in patients under 30 years with no other suspicious features
  • New asymmetrical nodularity (generalised unevenness or thickened areas rather than a discrete lump) that persists at review after three weeks

For more detail on breast lumps management see here

Nipple symptoms

Refer urgent suspicion of cancer

  • Serosanguinous nipple discharge (clear yellow liquid +- blood staining)
  • New unilateral and non-reversible nipple retraction
  • Unilateral nipple eczema if unresponsive to moderately potent topical steroids after a minimum of two weeks

For more information on non-cancer management see here

Skin changes

Refer urgent suspicion of cancer

  • Skin tethering
  • Unexplained new breast ulceration
  • Peau d’orange

Abscess/Infection

Refer urgent suspicion of cancer

  • Mastitis or breast inflammation which does not settle or recurs after one course of antibiotics

For information on non-cancer management of breast infection see here

Editorial Information

Last reviewed: 11/02/2026

Next review date: 11/02/2028

Author(s): Maria Bews-Hair.

Version: 2.0

Approved By: Scottish referral guidelines for suspected cancer