A 62-year-old woman has a new hard, irregular, fixed 2 cm breast lump. What is the correct pathway?
Answer and explanation
Correct answer: A. Urgent referral to the breast service on the suspected cancer pathway
- Step 1: Hard, irregular, fixed lumps are suspicious.
- Step 2: NICE NG12 advises urgent referral for an unexplained breast lump in those aged 30 and over.
Answer
Urgent referral to the breast service on the suspected cancer pathway.
Why not the others: Referral to physiotherapy for a suspected strain of the chest wall muscles: The chest wall explanation ignores the examination findings. Reassurance and review at the next routine screening round in two years: Waiting two years risks advanced cancer. A six-week trial of oral antibiotics before any referral is considered: Antibiotics are for mastitis, not a hard lump.
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