Breast lumps | Right Decisions

Refer urgently

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

Refer routinely

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

Primary care management

Women with longstanding tender lumpy breasts and no focal lesion
Tender developing breasts in adolescents
Longstanding nipple retraction
Nipple eczema if eczema present elsewhere
Obvious simple skin lesions such as epidermoid (sebaceous) cysts

Last reviewed: 27/05/2026

Next review date: 27/05/2028

Reviewer name(s): Maria Bews-Hair.