Breast – benign and malignant

Cat 1 · 30 days

appointment within 30 calendar days. - Diagnosed breast cancer: - early (confined to breast) - locally advanced (spread to involve areas near the breast) - secondary spread (involving areas outside the breast e.g. lymph node - Inflammatory breast cancer (rare, involves lymphatic spread causing inflammation in the breast) - Recurrent breast malignancy - Suspicious lesion on breast screening mammography or FNAC - Suspicious breast mass on clinical examination - Ductal carcinoma-in-situ (non-invasive confined to the ducts) - Lobular carcinoma-in-situ (non-invasive confined to lobules) Breast lump - New diagnosis or clinically suspicious of primary breast malignancy (biopsy or mammogram proven) - New discrete lump - Young women with tender, lumpy breasts - Asymmetrical nodules that persist at review after menstruation - Older women with symmetrical nodules provided that they have no localised abnormality - Any lump that increases in size - Cyst persistently refilling or recurrent cyst - New lump during pregnancy Breast pain - Continuous mastalgia - Localised areas of painful nodularity/ focal lesions Nipple discharge, nipple retraction, change in skin contour - Discharge sufficient to stain clothes - Blood stained discharge - Persistent single duct - Nipple retraction/distortion - Nipple eczema - Paget's disease of the nipple

Cat 2 · 90 days

appointment within 90 calendar days. - Benign breast disease for consultation - Low-risk breast lumps/cysts - Nipple discharge (non-blood stained) - Ductal papilloma - Fibroadenoma (diagnostic excision biopsy if diagnostic uncertainty) - Intermittent mastalgia i.e. hormonal - Gynaecomastia where there is substantial breast enlargement or significant breast tenderness and where breast size is disproportionate to body habitus

Cat 3 · 365 days

appointment within 365 calendar days. - Gynaecomastia - Prophylactic mastectomy