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Male Breast Symptoms

Checked: 23-07-2023 by Rob Adams Next Review: 23-07-2025

Overview

All referral guidelines and investigations needed for male breast symptoms are summarised in a clear, one page flow chart, via the following link. This is the current Association of Breast Surgery Guidance formulated specifically for primary care.

ABS - Primary-Care - Design - RCGPupdate.png

Useful patient information;

https://breastcancernow.org/sites/default/files/publications/pdf/bcc155_gynaecomastia_2018_web_0.pdf

Who to refer

Unilateral lump with no obvious physiological or drug cause - refer if diagnostic uncertainty that the lump is benign.
Patients with a unilateral breast lump and Kleinfelters / family history
Persistent painful gynaecomastia (> 6 months) with normal blood tests.

Refer to Breast Care Centre using 2WW referral form

Please note that referral is for diagnosis only in these cases. The Breast Clinic may be able to advise the GP on symptomatic control but are not funded to provide treatment, including medication prescribing. Tamoxifen treatment is not routinely commissioned, and is currently not on the BNSSG Formulary for this indication, so should not be prescribed.

Surgical treatment for gynaecomastia is not routinely commissioned in BNSSG ICB and is subject to the Breast Surgery (for Males) Exceptional Funding Request Policy.

Red Flags

Refer via Breast 2ww referral

>50 years with Unilateral hard mass in subareolar region or eccentric mass in ‘breast region’
Bloody nipple discharge
Unilateral nipple ulceration

Gynaecomastia

Please see the Gynaecomastia page in the Endocrine section of Remedy.

Breast abscess

Please see the Mastitis and Breast abscess page for the referral pathway for men presenting with a breast abscess.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.