What are the referral criteria for a patient with nipple discharge tha

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

Referral criteria for nipple discharge suspicious of malignancy:

Refer patients aged 50 and over presenting with nipple changes of concern in one nipple only, including nipple discharge and retraction, using a suspected cancer pathway referral.
For patients under 50, the guideline does not specify urgent referral for nipple discharge alone, but clinical judgement and other suspicious features should guide referral.

These criteria aim to identify breast cancer early in patients presenting with nipple symptoms that raise suspicion of malignancy.

Reference: Suspected cancer: recognition and referral (NG12)

What are the referral criteria for a patient with nipple discharge that raises suspicion for malignancy?