Lump found on breast but referral up to 2 months, Breast clinic saying this is wrong and GP saying this is a different route, anyone else not have 2 week wait?

[Goldenbear]

As title suggests - I had a GP appointment yesterday as I have a fairly painful lump at the bottom/side of my left breast. I went to the GP about this a year ago and they said they could feel a pea size lump but it wasn't anything to be worried about. This first started bothering me after I had my DD 8 years ago and I was told it was the underwired bra causing it. I got rid of those and to be fair it went away but these last few months I noticed the same irritation which does get more painful during my period. I was told by the GP yesterday that, 'yes' she could feel something but she's not worried and will refer me for an ultra sound but it will be 1-2 months.

When I returned home last night I read that it is a 2 week wait in these scenarios so as I was worried I went via the breast clinic this morning that is located next to the GP surgery and asked the receptionist. She was quite rude and sarcastic and said what I was saying was not true as it is always a 2 week wait and there is no other route. She told me to ring the Practice Manager to tell them that they are giving out the wrong information. I've just got off the phone to the Practice Manager who said there are two routes for referral and I'm in the non urgent one of 1-2 months. Does anyone have any experience of this same scenario or advice? I'm posting in Chat for traffic.

I don't have any direct experience, but I would assume the referral is non-urgent because your GP does not suspect cancer.

Are you under 30? According to this page:

"Consider non-urgent referral in people aged under 30 with an unexplained breast lump with or without pain (new NICE recommendation for 2015)."

If you are concerned, could you maybe see a different GP for a second opinion?

Agree with lemonjumper . My 2 week wait referral was entitled 'Suspected cancer' so it's possible they don't think it's cancer related, hence the non-urgent status. You could see another GP for your own peace of mind?

Two-week referrals are for if there is a possibility of cancer, and they don't muck about if they have any suspicion at all. I was recently referred within two weeks, with no mucking about at all, to a mole/skin clinic. They would rush you if they had any suspicion that they needed to.

I'd complain about the rude and sarcastic receptionist.

Thank you for all replying. I spoke to the Practice Manager yesterday and he confirmed what everyone is saying I. E there are two routes for referral etc. He also said that I should follow the information from the GP rather than the Breast clinic receptionist as she is not a trained medic.

I should add I'm 42.

DarlingNikita, sorry to hear that, i can see how that description must be very anxiety inducing. Hope things are working out well.

I guess it depends where you are. Here (Bucks) all breast referrals are 2WW regardless of age, sex or possible diagnosis there is no alternative route.

Hi OP,

I found a lump on my breast beg of Dec. Had GP appointment to be told they didn't think anything of it. Got referred and had my appointment Tuesday just gone. It's a lump for me and I had to have a biopsy and a mammogram. It's been ruled out that it's a cyst. I don't know when the results will be, but I'm bricking it. The doctors doing the ultrasound on me seems concerned I wasn't referred straight away though. So technically I'm guessing they would rush you through if the GP thinks it's urgent... mine clearly doesn't, but the doctors on Tuesdays faces tell a different story.

Are you in London?

Yes this is absolutely correct.

The problem with every breast issue being referred under a 2WW is that there just isn’t the capacity for it and women with actual suspected cancer have to wait behind women with breast pain/cosmetic implant issues/long term breast issues/cysts all of which do not need a 2WW.

Our 2WW ended up being a 4WW as we just could not offer the capacity needed to see everyone the GPs referred. 99% of who didn’t have cancer.

You’ve said yourself this is a long term issue which comes and goes, it’s very very unlikely to be cancer and those appointments are for women with symptoms indicative of a possible malignancy.

I’ve been in the horrible situation of having to offer a last minute cancellation to a woman who thought her cosmetic implant might be leaking when I knew the next person on the list after her was very likely to have cancer and absolutely deserved that appointment. But first come first served.

So the boob job got the appointment 4 days later and the cancer had to wait 4 weeks. There absolutely should be two pathways and I’m glad more trusts are offering them now and GPS seem to be being more responsible with their referrals.

Seems a mixed course of action depending on the part of the country.

Nonotmenori, I am sorry to hear that, horrible waiting game for you. So you had an initial diagnosis from the GP of not being that concerned but at the referral they were concerned? Did you have the 2 week wait or was it just over that?

I'm in Brighton, my husband has private health insurance with his work and was investigating whether he could put me on it but it's not something we can really afford. Ultimately though as 3drawercinemaclub pointed out I've had it a long time, it's just in the last couple of months it has become more noticeable, irritating and accompanied with pain.

@goldenbear, if it’s any comfort breast cancer is very very rarely painful.

We have an actual “breast pain” clinic so we could move those ladies off the 2WW.

There will always be the exception to the rule but the vast majority of breast pain is hormonal, the result of a badly fitted bra, or cysts.

I've been referred twice under the two week wait guidelines. Once in my twenties when it turned out to be a small cyst. And once in my forties when it was a very large cyst that needed to be aspirated. The second time I was seen within four days which was great as I was very anxious. The hospital did say after that appointment that I should always approach the gp if I got any lumps in the future and not just presume they are cysts.

Both times I was referred by the gp they said they thought it was a benign issue but until I was checked they couldn't be sure. I guess that's why they were classed as urgent referrals.

I appreciate what you are saying 3drawercinemaclub and you are right but this is my first experience with being referred for a lump and as GP appointments are short and I had my daughter with me, there wasn't time to discuss the two routes. The breast clinic is next door and a Mum I know who works there advised me to go along for me information. When I asked about my referral the receptionist had never heard of two routes, really insisted that the Doctor had got it wrong and that I should inform the practice manager immediately to let them know that the GP was giving out the wrong timescales. She was quite rude and dismissive and wouldn't listen to the idea that this other route could be a 'real' thing. So armed with conflicting advice it ramped up the anxiety.

if it’s any comfort breast cancer is very very rarely painful.

I agree with this. I was diagnosed with breast cancer this year and would have had no idea if I hadn't had my routine mammogram.

3drawercinemaclub, you are 'right' in your suggestion of the priority order of the two women. Sorry should have meant that. Yes, I've read that about the pain, so again, it's reassuring.

if it’s any comfort breast cancer is very very rarely painful.
Really? That's good to know as I have breast pain and am waiting for mammogram results (but am 46 and get yearly mammograms anyway).

@goldenbear

Sorry if I sounded dismissive, that wasn’t my intention at all and I understand the anxiety behind any kind of breast issue!

I’m just very passionate about the two pathways

I think if more women realised who they are waiting behind in the queue they would furious!

We were getting 40/50 referrals to the 2WW everyday. Even more if breast cancer had been on the TV or there was an article in the tabloids (you get a spike in referrals for the next week or so).

You would have women who you could clearly see from the referral probably had cancer or screening patients who definitely do have cancer waiting behind 20 year olds with a one week history of breast pain, men who were taking anabolic steroids and were concerned about the growth of their “man boobs”, women with cheap boob jobs and constant problems, itchy nipples and all kinds of stuff which suspected cancers should not be waiting behind. We don’t triage the waiting list at the hospital it’s first come referral first served referral and the GPs need to more responsible for who they refer.

@smemorata, as a general rule, BC is not painful. There is a rare kind of cancer which is painful (inflammatory BC) but you would have other symptoms. Is also painful if someone is aware they have a lump and ignores it and the cancer spreads to the point it erupts out of the skin.

The cases where people say they had painful breast cancer are usually a coincidence and they report pain and then the cancer is picked up very early, but that’s usually correlation not causation

Hi Golden,

Yes she didn't seem bothered or anything. Reckons it's nothing, but because I persisted, I got my referral. The hospital doctors did seem concerned I wasn't referred straight away. Im 36 and thinking the absolute worst. Good luck to you xx

Goldenbear, that's so kind of you to say. I should have said, it turned out to be nothing at all and the dermatologist was quite annoyed with my GP that he'd referred me, as I'd worried myself sick for two weeks waiting! But better to be overly cautious than to risk it going the other way, I think.

I would echo what others say about pain. Years ago I had a painful lumpy breast and convinced myself of the worst. My very nice GP very gently told me 'Cancer isn't painful', which was really reassuring, and I was eventually diagnosed with fibrocystic breasts, which can hurt but is definitely benign.

@Nonotmenori, crossing my fingers it turns out to be nothing! If it makes you feel better we biopsy lumps all the time which are nothing. Fatty lumps, weird tissue, fibroids etc. They can usually tell from the mammogram if it’s cancerous or not.

And honestly our doctors will give a “heads up” if they think it’s going to be bad news.

So “obviously we need to wait for the results of the biopsy but at the moment I do have to tell you it is showing signs of being suspicious for something else” - that’s the classic line.

I took 5 weeks to get an appointment. I think in my case the GP possibly didn't think it was urgent as I was relatively young and breastfeeding, and even said I could wait to see if it went away. I took the appointment and unfortunately it was cancer. Luckily the oncologist said the delay wouldn't have affected the prognosis. I understand they are stretched and have to work on probabilities. I'm in Scotland.

Young and breastfeeding really is a hard call to make and 9 times out of 10 it would be nothing. Really sorry to hear that.