Son (17) referred for 2 week cancer pathway

[cosietea]

I’m very anxious. Son has had a breast type lump for around 2.5 years which we were led to believe was hormonal, normal and part of puberty. It didn’t disappear as they usually do and hasn’t got bigger. Saw GP last week and did some hormone blood test and has now been referred to breast clinic under 2 week pathway for cancer
I am shocked and tried to get through to a GP today but couldn’t get past the receptionist who was less than helpful
his latest hormone results show this and were flagged ‘red’ even though last year they were higher and considered normal.
jf anyone is medical or understands this please can I have some advice on what this means please?

Hi, just popping in because I used to work in a breast clinic. Hormonal changes commonly cause cysts or benign growths.

Did the GP say why they were referring?
A breast clinic referral is still under 2ww if gp thinks benign like a cyst. And at your son's age something benign is much more likely.

Only 1:10 referrals to the breast clinic are malignant and then only 5% of those diagnoses are men, so highly unlikely to be cancer. He'll likely have an Dr or specialist nurse examination and then ultrasound, any doubt they'll biopsy or if a cyst maybe drained it there and then with a small needle. It's all very efficient usually!

I hope all works out well

Thank you so much for your response. I couldn’t get through to the GP today, reception practically blocked me as I didn’t have an appointment.

we thought this was a routine referral which is what the GP told us, so was shocked to see it’s a 2 week referral instead

GP here, OP. A lump which has been present for 2.5 years without significant change is very unlikely to be cancer. And remember that the vast majority of people referred on a 2ww pathway do not turn out to have cancer. I know it’s hard not to worry, but the chances of this being something serious are really very low.

With some body parts such as neck and breast, the only way to investigate is by 2ww, regardless of how concerning it is.

Thank you thank you. I appreciate the reassurance, you are bringing me down from a ledge right now.

Forgot to add this was the raised levels from last week. He actually had a higher level than this last year but it did not flag as abnormal but now it does? Not sure why. He had lots of UTI’s and antibiotics last year ( now cleared) and had full blood count in November with no concerns

I hope your son is OK OP. It must be a very worrying time for you all.

Thank you

Thank you

Thank you

Thank you

I’m a male, I can’t remember a huge amount as I’m in my 40’s now, but I had similar in my teens, I’ve still got the lump today, it was just a cyst, I never went down the draining route as was advised it wasn’t necessary and would more than likely come back, it’s never caused me any problems.
I know this doesn’t answer questions for you but I know the worry that comes with it.
The NHS are very belt and braces in my experience, which is amazing, but also does create worry. As posters above have said, very few people who are tested receive bad news.

We’re so used to hearing about NHS waiting lists that when we get a quick appointment the speed raises concern. However, the 2 week pathway at the breast clinic is one of the things that does seem to generally run to time. I was very surprised to get seen within two weeks for pain that neither my GP or I thought was cancer, but it turned out to be standard practice for any referral made to the clinic and not an indicator that anything sinister was anticipated.

He looks to still be well within the normal range for a growing male teen - at least according to: www.nwlpathology.nhs.uk/tests-database/alkaline-phosphatase-alp/

Maybe they are mistakenly using the adult male reference range, whereby his result would be considered high (i.e. over 130 IU/L)

As others mentioned, ALP is higher in children. Locally, all breast issues go via the 2 week pathway.

ALP can be raised in teens due to rapid bone growth. This is most likely unrelated and a non-issue. 2ww pathway is a great way to get things sorted out quickly and doesn't mean the GP definitely thinks it's cancer. Good luck to you and your son

Thanks, I haven’t told him the wording or nature of the appointment as it’ll freak him out and it’s unnecessary anxiety for him. What will likely be mentioned at the appointment? Will they mention cancer? The language used in the letter seems like a template but very clearly mentions cancer

Again, I can’t be much help, but I have had some unrelated tests recently, without going into too much detail, I’ve had symptoms that matched a certain cancer so had tests, the only time cancer was mention was “we’ll do such and such tests to rule out cancer/anything nasty.”

I would briefly mention to him that with any lumps, they will have to rule out cancer just in case they do bring it up.

My son was diagnosed with cancer last year, it sounds very unlikely to be cancer to me because the lump has been there for so long. Always worth getting it checked out though.

@Kirbert2 I’m sorry to hear that, hope he is doing ok.

It seemed to start out like female puberty ( one sided) initially looked like a breast bud behind the nipple and then appeared more like a small breast

He's doing good thanks. In remission for nearly 10 months now!

Update. His appointment went well, ultrasound and consultation confirmed this is Gynecomastia likely from puberty still in play.

No real options available to reduce the growth and to wait and see if it goes on its own ( I don’t think this is likely as it’s been like it for 3 years) and only permanent option is surgery ( not offered in NHS)

Very happy this is not something worse

what a relief for you all 💐

Great news. Thanks for updating us OP