Current patterns of referral in breast disease

The aim was to audit symptomatic referrals to this breast unit in 1998, in order to ascertain the main diagnosis in relation to age, and thereby identify the percentage and age of patients who were reassured and discharged without investigation. 3199 general practitioner referrals were seen in 1998. Of these, 8.7% (n=274) were diagnosed as cancer and 91.3% (n=2925) were given a non-malignant diagnosis. In those under 40 years, only 18 patients of the 1231 seen were diagnosed with cancer, and only one of these was younger than 30 years (29 years). Twenty-seven per cent (n=333) of women under 40 were diagnosed as normal, and of these 14% (n=174) had no investigation. We confirm the recommendations of the guidelines issued by the Department of Health, that in younger women without discrete lumps or family history, clinical examination and reassurance is adequate. This audit should therefore empower general practitioners, to confidently reassure the younger patient, without a discrete lump.