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referral criteria from primary care - gynaecomastia
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- GPs - When and Where to Refer (1)
- Abnormal endocrine (hormonal) blood results - note if a marginally raised
prolactin then repeat before considering referral
- Refer to Medical Endocrinology clinic
- Refer to Medical Endocrinology clinic
- Abnormal sHCG or alpha fetoprotein blood results or abnormal finding
on testicular USS
- Refer to Urology Clinic urgently
- Refer to Urology Clinic urgently
- Referral directly to the Breast Unit
- In the presence of the following clinical scenarios, a referral
directly to the local breast unit may be considered.
- 1. Clinical suspicion of malignancy
- >50 year old man with unilateral firm sub-areolar mass with or without nipple discharge or with associated skin change
- Bloody nipple discharge
- Unilateral ulceration of the nipple
- Urgent referral is appropriate
- 2. Unilateral lump with
- No obvious physiological or drug cause
- Increased risk - family history
- Genetic conditions e.g. Klinfelter's Syndrome
- Urgent referral is appropriate
- 3. Persistent painful gynaecomastia (>6 months) with normal blood tests
- 1. Clinical suspicion of malignancy
- In the presence of the following clinical scenarios, a referral
directly to the local breast unit may be considered.
- Abnormal endocrine (hormonal) blood results - note if a marginally raised
prolactin then repeat before considering referral
Reference:
- (1) Association of Breast Surgery Summary Statement (June 2019). Investigation and management of gynaecomastia in primary and secondary care.
Last edited 09/2019 and last reviewed 10/2020
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