Buying health services for local people

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Mastalgia (breast pain) – Information for GPs

Referral criteria / commissioning position

Refer if:

  • six months management within general practice does not resolve the situation

Red flag symptoms

  • If associated breast lump follow breast lump pathway
  • If associated nipple discharge follow nipple discharge pathway
  • If associated nipple distortion/ retraction follow nipple distortion/ retraction pathway
  • If evidence of inflammation consider the possibility of inflammatory cancer and refer as Fast Track if necessary, or the possibility of evolving abscess in which case follow Breast Infection Pathway

Investigations prior to referral

Pain chart

Information to include in referral letter

  • History and duration of complaint
  • Outline treatments already advised and tried including their effects
  • Number of consultations has had for this condition in last six months
  • Past medical/surgical history including any family history of cancer
  • Drug history (prescribed and non-prescribed)
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption

Patient information

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