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2630 pages added, reviewed or updated during the last month (last updated: 18/4/2021)


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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

    • Abnormal sHCG or alpha fetoprotein blood results or abnormal finding on testicular USS
      • 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

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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