Most breast changes are benign. All new ones should still be examined — and that means in person.
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Any new breast lump should be examined in person. That is the single most important line on this page, and it applies whatever your age and however unconcerned you feel.
Seek urgent assessment — within days — for:
Seek same-day care for: a red, hot, swollen, painful breast with fever — which is usually mastitis and needs antibiotics, but can rarely be inflammatory breast cancer if it does not respond.
Breast tissue changes constantly — with the menstrual cycle, with pregnancy, with weight, with age and with the menopause. Lumpiness, tenderness and fluctuating size are all normal, and the great majority of breast changes turn out to be benign.
That said, we want to be direct about the position of this service. Breast assessment requires physical examination, and physical examination cannot be done remotely. No photograph, however good, substitutes for a clinician feeling the tissue.
What a remote consultation can do is take a proper history, assess your risk, tell you clearly how urgently you need to be seen, and arrange the referral. Sometimes the most valuable thing an appointment provides is the right referral, quickly.
Breast cancer. Roughly one in seven women in the UK will be affected during their lifetime, and it is the reason the threshold for examination is deliberately low.
Survival is strongly linked to the stage at diagnosis. That is not a reason for alarm about every lump — most lumps are not cancer — but it is a very good reason not to wait and watch.
Some of the most important breast changes are visible rather than palpable, and they are missed entirely by people who only ever feel for a lump.
In front of a mirror, in good light, look at your breasts in three positions: arms relaxed at your sides; arms raised above your head; and hands pressed firmly on your hips to tense the chest muscles. The second and third positions reveal tethering that is invisible when you are simply standing still.
Then feel — the whole area, including up to the collarbone, into the armpit, and behind the nipple. Breast tissue extends further than most people realise, and the upper outer area towards the armpit is where a good proportion of cancers arise.
Breasts are normally lumpier and more tender in the week or so before a period. If you find generalised lumpiness at that point, check again a week after your period finishes — cyclical change settles, a genuine lump does not.
Do not use this as a reason to delay a discrete lump by more than one cycle. One reassessment is sensible; three months of waiting is not.
Men get breast cancer. It is much less common, but it is far more often diagnosed late — precisely because nobody expects it and the symptom gets ignored. A firm lump behind the nipple, nipple discharge, or nipple retraction in a man needs the same assessment as it would in a woman.
Painful, soft, symmetrical enlargement of both breasts in a man is usually gynaecomastia, which is common and different — but that is a distinction for a doctor to make, not you.
Any of the changes listed above should be assessed in person. Contact your NHS GP for a breast clinic referral, which runs on a two-week urgent pathway; or arrange a private breast clinic appointment directly. Do not delay because you feel awkward, because you are busy, or because you are probably being silly. The overwhelming majority of people referred do not have cancer, and the clinics exist precisely so that this gets checked rather than carried.
We will be clear about what this consultation is for. It is not a substitute for examination, and we will not tell you a lump is fine on the basis of a description.
What we do cover: how long the change has been present and whether it varies with your cycle; its character as you describe it; associated skin or nipple changes; your family history of breast and ovarian cancer, which materially affects risk and referral thresholds; your hormonal history; and any medication, including HRT.
We assess your risk profile properly, which is often not done, and which matters for people with a strong family history who may be eligible for earlier or more frequent screening.
Where examination is needed — which is essentially always for a new lump — we arrange referral to a breast clinic, and we do it promptly. UK breast clinics run a one-stop model: examination, imaging and, if needed, a biopsy in the same visit.
You can also go directly to your NHS GP for an urgent two-week referral, and if that is the faster route for you, we will say so. Getting seen matters more than who sends you.
Do not wait for a routine screening appointment if you have a new symptom. Screening is for people without symptoms; a new lump needs assessing regardless of when your last mammogram was, or whether you are in the screening age range at all.
There is no required schedule, and formal monthly self-examination is no longer what is advised. What is recommended is breast awareness — knowing what is normal for you, so that a change registers. In practice that means looking and feeling regularly enough to be familiar: in the shower, getting dressed, whenever suits.
What matters is noticing change, not following a ritual.
Generalised, symmetrical lumpiness that varies with your cycle is normal breast tissue, and it is particularly common in the 30s and 40s. The features that distinguish concerning from normal:
Comparing the two sides is the most useful thing you can do — symmetry is reassuring, asymmetry is what warrants a look.
Not all discharge is concerning. Milky discharge from both nipples can be hormonal or a medication effect; a little discharge on firm squeezing is common and usually nothing.
What needs assessing: discharge that is bloodstained or clear-and-watery, that comes from one duct in one breast, that appears spontaneously without squeezing, or that is accompanied by a lump. Milky discharge in someone not pregnant or breastfeeding also warrants a hormone check.
Like the skin is being tugged inwards from underneath — a small indentation, a pucker, or a flattened area that was not there before. Sometimes the texture becomes pitted, like the peel of an orange.
It is often visible only in certain positions, which is why raising the arms and pressing the hands on the hips matters. Dimpling is a significant sign and should not be watched; it warrants referral.
Yes — several hundred men are diagnosed in the UK every year. It usually presents as a firm, painless lump behind or beside the nipple, sometimes with nipple retraction or discharge.
The problem is delay. Men are far less likely to expect it, less likely to check, and more likely to be diagnosed at a later stage as a result. A lump in a man's breast is investigated exactly as it is in a woman's — examination, imaging and, if needed, a biopsy.
Yes. Screening finds cancers before symptoms appear; it does not guarantee that nothing will develop before the next round. Cancers that arise between screens are well recognised, and mammography is less sensitive in dense breast tissue, which is commoner in younger women.
A new breast symptom is assessed on its own, regardless of screening history. "But my mammogram was clear" is one of the more common reasons for a delayed diagnosis.
Usually a one-stop triple assessment, meaning you leave with most of your answers the same day: examination by a specialist, imaging — ultrasound under 40, mammogram and ultrasound over 40 — and a needle biopsy if anything needs sampling.
It is far less drawn-out than people fear, and the great majority of people referred are given the all-clear. That is what the pathway is designed to do quickly.
No, and it would be wrong to suggest otherwise — this is the clearest limitation on this site. A breast lump has to be felt, and the assessment depends on imaging and, where indicated, a biopsy. No amount of history or photography substitutes for that.
What a consultation can do is get you onto the right pathway quickly: take the history, judge urgency, write to your NHS GP the same day for a two-week-wait referral, or arrange a private breast clinic appointment directly. Given that speed is what actually matters here, that is not a small thing — but it is a routing service, not an assessment.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
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20 minutes
Yes, with your consent
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Yes, and told why
£40 for 20 minutes
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Typically 10 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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