Should I push for an urgent breast clinic referral?

[StacieBenson]

Hoping for some advice - I noticed a really small breast lump two months ago. I'm breastfeeding so I assumed it was related to that but it's now grown and the skin turned red over the lump. I went to the GP last week and the nurse prescribed me some antibiotics because she thought it was an infected breast cyst. These didn't do anything so I went back today and the GP said she didn't think it was a cyst, but they would prescribe more antibiotics. I challenged this as I think I should now be referred on to the breast clinic and I've since had a text message that they will refer me on but not under the 2ww. I guess my questions are:

1. Whether I should push more to be referred under the 2WW, presumably using the GP complaints procedure.

2. Should I just bite the bullet and pay privately?

They all seem very confident it's nothing to worry about and while statistically that's true, I'm not sure how they can be confident that's the case for me if they aren't sure what it is.

Not sure what 2ww is but I would absolutely push for a referral.

I am breastfeeding and felt lumps in both my breasts. Was a bit of a circle between the Health Visitor and a nurse and then eventually a GP. The GP said she has a low threshold to send people for referral even although she didn't think it was anything to be worried about, especially as it is on both sides. I had no redness but it was a question they asked me (not sure what that indicates).

If it's grown with antibiotics (and assuming massaging / using hot and cold doesn't help - guessing they want to rule out mastitis?) I would be extremely pushy and get that referral in asap. You know your body best and you need to strongly advocate for yourself.

As you say, it is likely nothing serious but they also don't know so it should be checked out.

I think they are usually fairly certain when something is suspect that a 2ww referral is needed. If they, although uncertain what exactly it is, don’t feel it’s a cancerous lump then they won’t refer on the 2ww pathway. If, after you complain, they try to expedite it, it may even be bounced back by the breast clinic.

If you have the money to pay privately that is probably best option as you may well wait weeks for your complaint to be responded to (iirc it’s 28 days at our surgery) they may not then expedite it in any case as a 2ww referral and, if they do, it could still be refused so you could be several weeks down the line before you even know if you will be seen earlier or not.

I was breastfeeding when I was referred (twice) under the 2ww. As it was, it was just lumpy breast tissue and the other time a stray lymph node. But as my GP said, she couldn't tell what a lump was just by feeling it so would rather the hospital was annoyed at the referral than miss something. I'd push back, and go private if they are dicks about it.

Definitely not mastitis. I've had mild mastits before and it's not that and/or a clogged duct.

See another GP and insist on a faster referral. Or go private. It's just not worth messing around with lumps like that.

I completely agree with this.

I was breast feeding and noticed a lump. Doctor told me it was nothing, but would refer me as she could see I “looked distressed.”. She was very dismissive.

7-10 days later a scan at breast clinic and told it was probably nothing, but biopsy taken. A week later; told I had breast cancer. No redness, no pain, lump moved, nothing to indicate it. I am
also young.

i would push for the referral under the 2WW. Everything is a little slow these days; and even if you get an appt, they might want to do a biopsy, scan etc and all these appts also take time. The more it’s delayed the longer everything will be.

also if you’ve had a lump for over 2 months and it’s not gone, personally I think that should raise alarm bells to a doctor ?!

I agree. I was honestly surprised they are so relaxed about it. I should have read up on the NICE guidelines but I honestly thought it was so obvious it needed referring on that I didn't. Thank you for sharing your experience. I really hope you are recovering well.

@StacieBenson
Please push for an urgent referral.
I have read about another poster, apart from @Bangersndmash, who also found a lump while breast feeding. Her GP was very lax and it took ages for her to get diagnosed.

@StacieBenson yws I would push, I thought they erred on the side of caution and over referee. This all happened in Oct-Nov so still finishing chemo. But what I will tell you, after going through every emotion going is that it is very treatable if caught early enough. Good luck.

Redness is usually a sign it is not cancer amd as you are breastfeeding it is highly likely to be related. However, any sinister cause needs to be ruled out. Well done for pushing back- it’s your health. Good luck.

Thanks everyone for your responses. I've not been able to get through to anyone today and a private hospital has had a cancellation come up on Friday so I've booked in with them. Going to be a bit ruinous but I keep telling myself it's just money, you can't take it with you.

@StacieBenson good luck. It’s better to know, and yes, it’s just money, nothing compares to your health.

also apologies for the awful typos, up all night with two LO and clearly wasn’t awake yet.

I did this once and the peace of mind on the same day was worth every penny.

I just have to cut in here. Former breast cancer patient myself. Of course redness can be associated with mastitis or infection but it is also a red flag symptom for inflammatory breast cancer so it would be wrong to say it’s not a sign.

@StacieBensonI am annoyed that your GP is being slow with this but glad you have the option to go private. I hope it’s absolutely nothing and just feeding related but it’s better to be safe. I’d complain to your practice manager and ask them to read up on Nice Guidelines. Good luck!

The 2wr pathway has particular criteria that you need to meet or it will just be rejected. However, around here, the local guidance is that all symptomatic breast referrals are triaged and seen asap even if not strictly 2wr so you might find you are still seen pretty quickly. If you are on the NHS app you might be able to see the stage your referral is at which should give you an idea

Yes but isn’t that mainly on older patients? OP is a breast feeding mum so as I said it needs to be ruled out but signs are it’s likely to be related to that.

No. It was the first symptom for my friend with IBC at 40. Any symptom at all should be checked out in my view. My practice nurse told me I didn’t need a referral as it was probably “just a cyst”. I made a fuss and thank God I did.

Please don’t spread misinformation. Redness can indeed be a sign of cancer. As can a simple spot on the breast.

BC survivor here. Young.

Can I ask about a spot being a sign? I had a spot where the lump now is.

If it’s a spot that’s gone it’s probably ok but please just get checked out

Really not my intention to spread misinformation. It is just what I have read. Inflammatory breast cancer is extremely rare. have said sinister causes should be ruled out but odds are on OP’s side that it’s related to breastfeeding.

Hi OP, did you get any more answers?

Hi, it was absolutely nothing. Just an infected breast cyst.

Well done so pleased for you