# Breast cancer - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Breast Cancer - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK482286/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD27 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Menon G, Alkabban FM, Ferguson T. Breast Cancer. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Breast cancer - disease-level clinical article (breast-cancer-full.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text BREAST CANCER Sources: Breast Cancer - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK482286/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD27 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Menon G, Alkabban FM, Ferguson T. Breast Cancer. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care, Breast cancer - disease-level clinical article (breast-cancer- full.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (5) - Pain and a rapidly enlarging breast lump, often with itching and skin swelling [breast lump · itching] - Swollen lymph nodes or localized pain can be the presenting complaint, depending on disease extent [breast pain · lymphadenopathy] - Symptoms develop quickly, over weeks to months - Lack of improvement after antibiotics given for presumed mastitis prompts further evaluation - About 10% of cases are first picked up by an abnormal screening mammogram rather than symptoms SIGNS - what you find (4) - Breast shape may look distorted or enlarged, with orange-peel skin that feels warm and thickened - Nipple changes can include crusting, redness, flattening, blistering, or retraction [crusting · redness] - A discrete lump may or may not be felt on exam [breast lump] - Almost all patients already have lymph node involvement by the time they present TESTS (10) - Diagnosis rests on the clinical picture plus a core needle biopsy showing invasive carcinoma - A diagnostic mammogram is done on the affected breast and a screening mammogram on the other side - Mammography may show a mass, a large area of calcification, or distorted tissue with skin thickening - Mastitis can look similar on mammogram when inflammatory cancer has no underlying mass - Lack of response to a short course of antibiotics, under a week, is an indication for biopsy - Ultrasound may show thickened skin, fluid between tissues, and disrupted normal tissue planes - MRI shows multiple small, merging, enhancing masses with diffuse skin thickening - MRI is the most accurate imaging study for locating the primary breast lesion - PET/CT adds information on lymph nodes and distant spread during initial staging - All tumors are tested for hormone receptors and HER2 status, as with other invasive breast cancers IF NOT THIS - what else fits (4) - Ductal ectasia is a benign, self-resolving condition in middle-aged women from duct debris and swelling - Infectious mastitis in a nursing mother causes fever and a raised white count, usually resolving with antibiotics - Locally advanced noninflammatory cancer with skin dimpling, nipple retraction, or nodules can be hard to distinguish from the inflammatory form - Breast lymphoma or leukemia can mimic the presentation and needs biopsy to differentiate Source StatPearls "Inflammatory Breast Cancer" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult The most common cancer among Egyptian women. Definitive treatment (surgery, chemotherapy, radiotherapy, endocrine therapy) is oncology-led and not something a GP prescribes, but the GP plays a real role in early recognition of a lump or suspicious finding, prompt urgent referral, and advising on screening (clinical breast exam, mammography). - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why The most common cancer among Egyptian women. Definitive treatment (surgery, chemotherapy, radiotherapy, endocrine therapy) is oncology-led and not something a GP prescribes, but the GP plays a real role in early recognition of a lump or suspicious finding, prompt urgent referral, and advising on screening (clinical breast exam, mammography). Caution No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. RED FLAG - Rapidly progressive inflammatory skin changes (erythema, edema, peau d'orange) that fail to improve after a short course of antibiotics (less than a week) require urgent biopsy for underlying malignancy. RED FLAG - Nipple changes including crusting, erythema, flattening, blisters, or retraction indicate potential breast malignancy. RED FLAG - A new breast lump, especially one that is hard, fixed or irregular; nipple retraction or discharge, particularly bloody; skin dimpling or orange-peel change; or enlarged lymph nodes in the armpit: refer urgently. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)