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What are the options for diagnosis & treatment?

8 REPLIES 8
Guest user
Not applicable

Re: What are the options for diagnosis & treatment?

Hi Kerri I agree with what's already been said above. Your doctor cannot possibly know whether the lump is cancerous or not and you should be referred for testing whatever your age. Do go back to your GP immediately and request urgent referral. If she is reluctant to do this because of your age (if you are under 30) then please point out that more younger women are being diagnosed with cancer and you really do not want to wait. Have you thought about taking someone into the consulting room with you for moral support? (If you are a younger woman then you might find that your GP might take more notice of someone older.) Insist and don't leave until you get the referral (urgent so you are seen within two weeks). Hopefully, it will be nothing to worry about but you need to have it properly checked out and tested ASAP.

Best wishes
Francine x

Guest user
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Re: What are the options for diagnosis & treatment?

get referred Just wanted to add to what supersue said, don't be bamboozelled, go back to the GP, or another in the practice, and get referred NOW.

Good luck

Irene

SuperSue
Member

Re: What are the options for diagnosis & treatment?

Urgent message for Kerri Hi Kerri,

It isn't enough for your GP to be "pretty sure there's nothing to worry about". A GP cannot tell whether lumps are benign or not.

Basically if you find a lump and your GP agrees there is a lump you should be referred urgently, even though most lumps will be found to be benign. It doesn't matter where the lump is in the breast or if a woman is obese or not. It doesn't even matter if you've found a benign lump in the past. Any new lump needs an urgent referral and its own investigation.

I can say this because it's in all the official guidelines.

Details of guidelines.

Referral guidelines are very clear. If you live in England or Wales it is the NICE guidelines that you need to refer to. Scotland is covered by the SIGN guidelines.

[Other guidelines saying the same thing are - the Royal Society of Radiologist guidelines, the British Association of Surgical Oncology Guidelines and guidelines as far away as America, Canada, India and Australia.]

In Scotland the SIGN guidelines can be found at
http://www.sign.ac.uk/pdf/sign84.pdf

Assuming you live in England or Wales, the NICE guidelines on breast cancer can be found at:
http://www.nice.org.uk/page.aspx?o=csgbcguidance

They state:

URGENT REFERRAL (within two weeks):
¢ Patients aged 30 or over (the precise age criterion to be agreed
by each network) with a discrete lump in the breast.
¢ Patients with breast signs or symptoms which are highly
suggestive of cancer. These include:
¢ Ulceration
¢ Skin nodule
¢ Skin distortion
¢ Nipple eczema
¢ Recent nipple retraction or distortion ( 3 months)
¢ Unilateral nipple discharge which stains clothes

CONDITIONS THAT REQUIRE REFERRAL, NOT NECCESSARILY URGENT:
¢ Breast lumps in the following patients, or of the following types:
¢ Discrete lump in a younger woman (age 30 years)
¢ Asymmetrical nodularity that persists at review after
menstruation
¢ Abscess
¢ Persistently refilling or recurrent cyst
¢ Intractable pain which does not respond to simple measures
such as wearing a well-fitting bra and using over-the-counter
analgesics such as paracetamol.
Bilateral discharge sufficient to stain clothes in patients
aged over 50 years.
¢ Bloodstained discharge in patients aged over 50 years (urgent
referral required if discharge is unilateral).
¢ Any nipple discharge in patients over 50 years of age.

In short: if your GP has agreed that there is a lump and you are older than 30 years of age he/she should have referred you urgently so that you are seen within two weeks. The guidelines are entirely unambiguous about this.

If you think there is a lump but your GP doesn't then ask for a review just after your next period. This is when breast tissue isn't quite so full and a lump is most easily felt. If you can't agree on whether or not there is a lump then ask to be referred anyway.

Having said all of this most lumps are benign so don't panic but the best way of being sure is to be referred to a breast consultant to have the appropriate tests done. And you are not wasting anyone's time ; I repeat, you are not wasting anyone's time . Breast clinic consultants are just as pleased if a lump is found to be benign as the woman concerned and they won't be at all happy if your GP hasn't referred you in a timely fashion.

Further information just in case you are referred.

If you are referred and the consultant can feel a lump then he/she should carry out the Triple Assessment.

the Triple Assessment consists of three things:

1. Clinical Examination - the consultant examines both breast and checks for lumps and any asymmetry.
2. Imaging - this involves either mammography or ultrasound. (Ultrasound tends to be carried out in younger women or in women with dense breast tissue.)
3. Histology - cells are taken from the lump by either fine needle aspiration or core biopsy and sent to a pathologist for examination.

Together these three things have an accuracy of 99.6%. The Triple Assessment is recommended by all the guidelines.

Let us know how you get on. Again don't panic. Most lumps are benign but as we all say on this website - get it checked out.

With very best wishes and good luck,

Sue

Guest user
Not applicable

Re: What are the options for diagnosis & treatment?

What are the options for diagnosis & treatment? I just wanted to say thanks to those who replied to me. It was useful information. I saw the doctor & she's pretty sure there's nothing to worry about. She wants me to go back in a few weeks or sooner if I feel the lump is getting bigger (at the moment it's very small - not even the size of a pea), or if I notice any other changes.

We had quite a long chat about things & I feel ok aboout things. I feel it's ok to go back to her any time to talk - she was very sympathetic.

I would like to say to anyone reading this if you are worried about anything, go & see your doctor as soon as possible. If it turns out, like me, to be harmless, then your mind will be put at rest -don't feel embarrassed that you have wasted the doctor's time - you haven't! It's part of their job. If there is someting there that needs to be sorted, then the earlier you see the doctor, the better.

Guest user
Not applicable

Re: What are the options for diagnosis & treatment?

choice of hospital I personally having experienced what I thought was substandard care at my local general hospital would always now ask to be referred to the nearest cancer centre of excellence for breast cancer. And as an urgent case

Mole

BCC_Host
Member

Re: What are the options for diagnosis & treatment?

Publication Dear Kerri

I have posted below a link to a Breast Cancer Care publication Referral to a breast clinic that you may find helpful prior to your appointment on Monday.

http://www.breastcancercare.org.uk//docs/referral_07_0.pdf

Hope this is of help

Kind Regards
Forum Host
Breast Cancer Care

clairemm
Member

Re: What are the options for diagnosis & treatment?

Hi there I am sorry to hear you have found a lump I hope all goes well when you see your doctor. I was told that the waiting time to be refered was 2 weeks to be seen at a breast clinic.once seen if the breast care nurse is concerened they may well do a needle biopsy there and then and if they are still not happy they will call you back for mamogrames.
Make sure you tell your gp that you want to be put down as an urgent case, I was put down as non urgent due to my age then 24 and I had to wait 4 months to be seen and was diagnosed with aggressive bc.
With regards to treatment if you are diagnosed then things move very quickly. I am not sure you can chose whick hospital you are refered to but there is no harm in asking.
Once again I wish you all the best for monday.
Love Clairemm x x x

Guest user
Not applicable

Re: What are the options for diagnosis & treatment?

What are the options for diagnosis & treatment? I have just found a lump & am seeing the doc on Monday. While I trust her, I don't trust the local hospital - it is one of the worst in the country.

I just wonder what people think. What is available? Can I insist on going to a different hospital? What is an acceptable waiting time mammograms / tests etc? & If i do need treatment, what is the maximum acceptable time to wait.

I've heard people say that they have waited months, just to get a diagnosis, let alone treatment. Surely this is wrong.

I want to be able to go to my doc on Monday armed with info on how it all works so that I get diagnosis / treatment as early as poss. I guess I don't believe that hanging around for the NHS to get it's act together is actually going to help!! So I want to be proactive to give myself the best chance

Guest user
Not applicable

What are the options for diagnosis & treatment?

What are the options for diagnosis & treatment?