Breast: Key Points

Incidence:	Approximately 32,000 new cases p.a. in England and Wales. Breast cancer is the commonest malignancy to affect women.
Age:	Incidence increases with age. 5% of cases occur before 40 years and only 2% before 35 years.

A GP with a list of 2000 patients can expect to see one new patient with breast cancer per year, but will see a considerably larger number of women with benign breast problems.

Other breast problems include:

Diffuse nodularity:	common in all age groups up to 50 years.
Fibroadenoma:	peak age range 20 – 30 years.
Cysts:	peak age range 40 – 60 years.
Breast pain/mastalgia:	pain alone is a very uncommon presentation of breast cancer.

Presenting features of symptomatic cases of breast cancer:

Lump	90%
Painful lump	20%
Nipple change	10%
Nipple discharge	3%
Skin contour change	5%

Note: The guidelines for urgent referral of patients with suspected breast cancer in this document are based on those set out in ‘Guidelines for Referral of Patients with Breast Problems’ second edition 1999 prepared by Joan Austoker and Robert Mansel under the auspices of the NHS Breast Screening Programme and the Cancer Research Campaign.

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