Would you trust GP regarding breast lump

[Notateacher2020]

Hi all,

In summary- smooth flat/slightly rounded disk sort of thing in breast. Perfect circle. Like a squashed very small grape! Not omg noticeable but I've felt it so its there.....
Went to GP this week, one whom I feel has lots of experience and I usually trust whole heartedly with other things. Mental health for example.

She felt lump and said it's too smooth to be cancer. She has felt cancer and it doesn't feel like that. She said it feels like normal tissue or glandular. She told me to forget about it.

Would you? Without a scan? I really want to trust her but have a little voice in my head, what if.
Suffer with a little anxiety in general so that doesn't help things.

What are your thoughts?

Sorry, For context I am mid 30s !

No I wouldn’t accept that. Whilst she’s probably right you can’t tell 100% by feeling so she should refer you on

Honestly I would push for a referral to the breast clinic for your peace of mind
.

A breast cancer specialist could probably tell whether your lump was worrying or not, but they'd still need a scan of some sort to confirm. I wouldn't imagine a gp has THAT much experience.

Having said that, it would give me a degree of comfort until ultrasound or mammogram results were returned.

I had a breast lump and, never having had one before, I didn't know how it should feel. It was like a lump inside but not quite attached to my body. Very difficult to describe. When DM had breast cancer and I felt her lump, it was entirely different. It felt like a thickened and dense part of her breast tissue.

I saw a GP about a similar lump some years ago. She said it felt quite small and smooth and was probably nothing to worry about. But as I have a cousin who had breast cancer she agreed to refer me for further investigation. Sure enough, the scan revealed a small cyst, which was drained there and then. So yes, I think it's possible that an experienced GP can recognise the difference between a harmless lump and something potentially more sinister. But if you have any family history it should be followed up. And keep an eye on it. Check regularly for any growth or changes to the skin or nipple, or any other swellings. Check armpits and neck as well as breasts. And at the end of the day you know your own body, so if something really feels "wrong" to you, get a second opinion.

No she should refer you to the breast clinic, where they would usually do an ultra sound and then still if not sure a biopsy.

Thanks so much for your replies!
That's made my mind up.
I have called GP and asked for a referral, they said doctor wants to speak to me first and can't call me until next weds!

I think the Dr must be very confident that it's fine to say this - so try not to worry. However I think it's probably best for peace of mind if you do ask for a referral just to be totally sure.

As others have said it will probably be a very quick ultrasound and that will be that, but you'll feel so much better.

No, my DSis has breast cancer and was initially told not to worry by her GP.

I had vague lumpy bits (menopausal and just tissue changes) and got sent to the breast clinic within days. Some GPs are shit and dismissive and should be struck off

Oh gosh elfycat how awful. Makes me worry about waiting until next week now...

No family history at all, thankfully. I check myself monthly. It is a new change but not the "rock type of lump" that the GP said i should worry about...she is usually a very considered GP. Very kind.

No, I would want a referral to a breast clinic.

Thank you - I'm definitely going to push for a referral.

Would everyone be happy to wait until weds to discuss with doc....?

I'd want to be referred for any breast lump. My GP felt a slight ridge which he said was probably tissue but that coupled with some pain meant he referred me. His feeling was better to be safe than sorry.

Haven't RTFT but just be aware that referral to a breast clinic doesn't mean you will automatically have a scan. I was referred during the first lockdown after a telephone appt with the GP, our area had agreed to refer everyone without the need for a duplicate GP examination for covid reasons. The clinic contacted me and I had a telephone consultation with a nurse a couple of weeks later, she wasn't concerned and said she'd call back in 3 months or so. At that point as I felt it was still there she booked me to come in. I was examined by a specialist nurse who didn't think it was anything to worry about and just normal breast tissue, no scan offered and sent me home. So given your GPs examination, even if you got referred you're highly unlikely to be offered a scan as the person examining you is highly likely to be a nurse and it's highly likely they will agree with your GP.

My GP didn't quite say that she did not think my lump was cancer, but it was clear she wasn't worried. But she referred me anyway in the 2 week pathway, because all lumps should be checked

She was right, it was a benign cyst. But we only knew that for sure because of the mammogram and ultrasound.

Most (>90%?) lumps are benign, so please don't be at panic stations. But I would push for a referral, that's what the pathway is there for

Thank you Meadowhay- maybe just a second opinion would give me a bit more confidence

I'm not an expert but I think tumours are usually attached via lots of blood vessels.
That's why it's called cancer, because it looks like a crab.
If that's true surely the nature of the lump is a telltale sign.

Thanks everyone for taking the time to reply. I feel better even knowing that I have a 'next step' now.

Now that's interesting @Springingintospring

I'm post menopausal now, but in the years I was peri menopausal I had a few cysts. They were as you describe, soft, very round and smooth. They always sent me for an ultrasound and I had a few syringed.
I think the doctor is sure it's nothing but you're absolutely right to push for a referral OP.

Thank you @augustusglupe. I will do x

It is the norm that breast cancer lumps present as ‘rough’ and ‘spikey’ and don’t move in the same manner as a cyst, as they are attached to something. Cysts don’t have to be attached.

That said, all lumps are investigated by my NHS Trust. I’ve a family history of breast cancer and was referred immediately - seen within 4 days. My lump was spikey & didn’t burst when the cone needle was inserted (cysts often do).

Wasn’t cancer though. Point is - only true investigation will give a diagnosis. Push.

NICE guidelines say everyone should be referred, but speed of referral will depend on your age.

If you know what the pathway should be for you, when the GP says oh it's fine you can just say 'but NICE guidelines say'.

I have quite a bit of experience in this area, being a person who is both naturally quite lumpy in the breast department, and also with a fairly significant family history. I go to the breast clinic fairly often.

I think your GP is probably right, and in my experience there are some GPs who are just very very good at knowing what needs investigation and what doesn’t. That said, if you want to see the breast clinic and get an ‘expert’ opinion I think that’s fair enough. Just ask her politely. She will likely just want to reassure you. She might say that she will do a non urgent referral also.

@Lonecatwithkitten and @YellowandGreenToBeSeen
I've just looked at the NICE guidelines and I'm over 30 with an unexplained lump (in my eyes at least). So that is useful for my convo with the doctor, thank you both.