Breast Pain course for GPs



This session describes the presentation and categorisation of breast pain, the assessment of affected women in primary care, their initial management and the indications for referral.
This session was reviewed by Khyati Bakhai and last updated in August 2020.
Learning Objectives
By the end of this session you will be able to:
- Demonstrate knowledge of the causes and presentation of cyclical and non-cyclical breast pain in primary care
- Demonstrate an understanding of the importance of risk factors in the diagnosis and management of breast pain
- Demonstrate a reasoned approach to the diagnosis of breast pain using history, examination, incremental investigations, and refer appropriately
- Intervene urgently with suspected malignancy and have a low threshold for the referral of breast lumps
- Describe the issues relating to the use of chaperones and detect whether the female patient wishes to see a doctor of the same sex
Breast pain (mastalgia) is experienced by up to two thirds of women at some time, and in two thirds of cases pain is cyclical. Most breast pain is minor or moderate, and responds to simple measures such as a supportive bra and occasional use of non-steroidal anti-inflammatory medication. Some women however have more significant symptoms and require intervention or referral.
Before commencing this session you should:
- Have an understanding of the presentation and epidemiology of breast cancer
- Have an awareness of local breast clinic referral guidelines
Mary qualified in 1988 and is a GP, trainer and course organiser in Haverhill, Suffolk. She is also an MRCGP examiner and casewriter. She writes extensively for educational journals such as Update, Practice Nurse and GP, and has written and edited general practice textbooks in addition to several novels.
Her main interests in medicine are paediatrics, child protection and expedition medicine. Mary is also involved in GP politics.

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