How should I approach the investigation of a palpable breast lump in a premenopausal woman?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Approach to investigation of a palpable breast lump in a premenopausal woman:

  • For women under 30 years presenting with an unexplained breast lump, consider a non-urgent referral for specialist assessment rather than an immediate suspected cancer pathway referral.
  • For women aged 30 and over with an unexplained breast lump, refer urgently using a suspected cancer pathway referral.
  • Assessment should include clinical examination and may involve imaging such as ultrasound, especially in younger women, to characterise the lump.
  • Further management and investigation depend on clinical findings and imaging results, with specialist advice sought as appropriate.

This approach balances the lower risk of malignancy in younger women with the need for timely investigation in those at higher risk.

References:

Educational content only. Always verify information and use clinical judgement.