Referral to a breast clinic

You will probably find that you develop your own way of coping during this uncertain time. It may help to talk things through with friends or family, or to keep yourself busy.

Although these feelings are likely to continue until you get your results, it may be reassuring to know that most breast problems are benign.

Your appointment

Your GP (local doctor) will follow a set of NHS guidelines when deciding whether or not to refer you to a breast clinic.

Usually they will only refer you if you have a new change in your breast such as a definite lump, a new puckering or dimpling of the breast, changes in your nipple, including a rash or discharge, or breast pain that is severe and persistent.

The Department of Health has recently implemented guidance on the referral of patients with breast symptoms. Under this guidance all patients referred to a specialist with breast symptoms, even if cancer is not suspected, should be seen within two weeks of referral by a GP. This differs to what was offered previously, where if your GP felt the referral was urgent, you would be seen within two weeks of them requesting an appointment for you. And if the referral was non-urgent you may have waited longer. It may take some time before this guidance is implemented in all areas and waiting times may differ in Scotland and Wales. If you have any queries about the waiting time for your appointment talk to your GP.

It is important to remember that if you are referred to a specialist, urgently or otherwise, the problem may still turn out to be benign (non-cancerous).

What to expect at the clinic

A doctor or specialist nurse experienced in diagnosing and treating breast problems will see you first. They will ask you for details of your symptoms. You may be asked to fill in a short questionnaire including questions about any family history of breast problems and any medication you are taking.

This will be followed by a breast examination where the doctor or nurse will check both your breasts when you are sitting and when you are lying down. As part of the examination it is usual to examine the lymph glands in your armpits. You may then need to have further tests. These will usually include one or more of the following:

• a mammogram (breast x-ray)
• an ultrasound scan
• a fine needle aspiration (FNA)
• a core biopsy.

Not everyone will require an FNA or core biopsy. This will depend on your symptoms and the findings of the radiological imaging (mammogram/ultrasound).

A clinical examination, radiological imaging and FNA/core biopsy of the breast is known as a triple assessment. Sometimes all of these tests can be carried out on your first visit with the results being available later that day. This is known as a one-stop clinic.

However, in some hospitals this isn’t possible and you may have to make another appointment for further tests or to get your results. You may have to wait up to a week for your test results, although this will vary with each breast clinic. Ask your GP for information on what is available at your local hospital.

To find out more about the tests you may have, visit our Types of test page.

Visit the Royal College of Radiologist website to take a virtual tour of a radiology department in your hospital to find out more about what you can expect.

Getting your results

The hospital will let you know about an appointment to return for your results. It may be a good idea to have your partner or a close friend or relative with you when you get your results. That way you can be sure of support from someone who cares for you, should you need it. They may also think of questions that hadn’t occurred to you and remember things you may forget.

For the majority of women triple assessment will show nothing more serious than a specific benign breast condition. In this case the specialist will explain what it is and whether you need any treatment or follow up.

If your results show that you have breast cancer you may feel all sorts of emotions such as shock, fear, anger and helplessness, and you may find it hard to take in what you are being told. Having someone with you who can listen carefully or ask questions can be very helpful.

You will also meet, or be put in contact with, a breast care nurse who will talk to you about your diagnosis and treatment. She will provide you with support and written information and can be a point of contact for you throughout your treatment and afterwards.

Whatever happens at the breast clinic, it is still important to be breast aware. Breast awareness means getting to know how your breasts look and feel, so you know what is normal for you. If you notice any changes that are unusual for you, go and see your GP as soon as you can.