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2015 NICE guidelines for referring patients with breast symptoms

​​1.4 Breast cancer

1.4.1 Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer if they are:
  • aged 30 and over and have an unexplained breast lump with or without pain or
  • aged 50 and over with any of the following symptoms in one nipple only:


    • discharge
    • retraction
    • other changes of concern. [new 2015]
1.4.2 Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer in people:
  • with skin changes that suggest breast cancer or
  • aged 30 and over with an unexplained lump in the axilla. [new 2015]
​
1.4.3 Consider non-urgent referral in people aged under 30 with an unexplained breast lump with or without pain. See also recommendations 1.16.2 and 1.16.3 for information about seeking specialist advice. [new 2015]

Unexplained Symptoms or signs that have not led to a diagnosis being made by the healthcare professional in primary care after initial assessment (including history, examination and any primary care investigations).

Reference:

http://www.nice.org.uk/guidance/NG12/chapter/1-recommendations#breast-cancer