Breast disease: a free MRCS Part A question

NICE NG12 separates breast lumps by age. A suspected cancer pathway referral is made for people aged 30 and over with an unexplained breast lump, with or without pain; for those under 30 with an unexplained lump, a non-urgent referral should be considered, because cancer is uncommon and most lumps in this group are fibroadenomas or cysts. A two-week suspected cancer referral would be correct were she 30 or older. Mammography is not the first imaging test in a young woman, whose dense breasts make it insensitive, and it should be part of triple assessment in clinic rather than arranged in primary care. Dismissing a persistent new lump without assessment is unsafe. Genetic referral depends on family history, which is not described. Reference: NICE NG12.