Breast Lump

Breast cancer is the most common (non skin) cancer in affecting women in Scotland, with more than 5,000 new cases each year. Breast cancer is much less likely in men, with approximately 40 cases per year in Scotland.

Incidence rises from age 30 in women (>99.5% cases are in women aged 30 yrs or over) and from age 45 in men (>90% of new cases are in men aged 45 or over).

Most breast cancers are diagnosed at an early stage (1 or 2). Stage distribution differs by deprivation, with women living in more deprived areas being more likely to experience an advanced stage breast cancer diagnosis.

USC Referral should be made for:

• New breast lump in a person aged 30 years or over
• New breast lump in a person aged under 30 who also has other suspicious features such as an axillary lump, nipple or skin changes (as below) or a significant family history of breast cancer
• New, unexplained axillary lump (2 cm or more in size, persisting for six weeks or more, or increasing in size) – please see details on Breast – Axillary Symptoms page

(Details of other indications for Breast USC referral can be found under pages for Nipple symptoms, Skin changes and Breast Abscess).

Consider a non-USC referral for a person with:

• New asymmetrical breast nodularity (generalised unevenness or thickened areas rather than a discrete lump) that persists for three weeks or more 
• A new breast lump under 30 years of age but with no other suspicious features (described above under USC referral)

Published data has shown that transgender women have a higher risk of breast cancer compared to men, and transgender men have a lower risk of breast cancer compared to women. In transgender women the risk of breast cancer is associated with hormone treatment. In cases of gender reassignment, it is important to provide sensitive and clinically appropriate care depending on individual circumstances and considering any hormone therapy involved. (Scottish Referral Guidelines for Suspected Cancer July 2025)

TF, EC, LP & JB FEB 26