GP Vivas · womens-health
Breast symptoms in general practice — structured viva
Structured oral on breast symptoms: defending the triple assessment pathway, mastalgia evidence, the discharge decision tree, and managing the frightened woman with a benign diagnosis.
On this page
Study tools
Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Every week a woman leaves your practice with breast pain and a clean bill of mind. How sure are you?' The viva branches through the cancer-risk numbers, the triple assessment, mastalgia treatment, and the reassurance gap.
Stem
You are the GP. A colleague says women with breast pain "never have cancer — just reassure them". [5]
References28ShowHide
- [1]Khawaja AR, et al. Has the breast cancer 'two week wait' guarantee for assessment made any difference? Eur J Surg Oncol, 2000.PMID 11034802
- [2]Clarke D, et al. Replace fine needle aspiration cytology with automated core biopsy in the triple assessment of breast cancer Ann R Coll Surg Engl, 2001.PMID 11320918
- [3]Meechan GT, et al. Who is not reassured following benign diagnosis of breast symptoms? Psychooncology, 2005.PMID 15386770
- [4]Mansel R, et al. A phase II trial of Afimoxifene (4-hydroxytamoxifen gel) for cyclical mastalgia in premenopausal women Breast Cancer Res Treat, 2007.PMID 17351746
- [5]Clegg-Lamptey JN, et al. Breast cancer risk in patients with breast pain in Accra, Ghana East Afr Med J, 2007.PMID 17892195
- [6]Ghimire B, et al. Accuracy of triple test score in the diagnosis of palpable breast lump JNMA J Nepal Med Assoc, 2008.PMID 19079392
- [7]Donnelly J Breast lump detection: who is more accurate, patients or their GPs? Int J Clin Pract, 2010.PMID 20015214
- [8]Goyal A Breast pain BMJ Clin Evid, 2011.PMID 21477394
- [9]Jan M, et al. Triple assessment in the diagnosis of breast cancer in Kashmir Indian J Surg, 2010.PMID 23133217
- [10]Kataria K, et al. A systematic review of current understanding and management of mastalgia Indian J Surg, 2014.PMID 25177120
- [11]Nakhlis F, et al. Papilloma on core biopsy: excision vs. observation Ann Surg Oncol, 2015.PMID 25361885
- [12]Saghafi N, et al. Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial J Obstet Gynaecol, 2018.PMID 29072514
- [13]Mišković J, et al. Diagnostic Value of Fine Needle Aspiration Cytology for Breast Tumors Acta Clin Croat, 2016.PMID 29117654
- [14]Zhou Y, et al. Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis Br J Cancer, 2018.PMID 29182609
- [15]Mazari FAK, et al. The need for triple assessment and predictors for diagnosis of breast cancer in patients <40 years of age Clin Radiol, 2018.PMID 29731127
- [16]Quinlan A, et al. Quantifying patient preferences for symptomatic breast clinic referral: a decision analysis study BMJ Open, 2018.PMID 29858402
- [17]Barakzai N, et al. Is conservative management of fibroadenomas feasible? 5-year results from the Durban Breast Unit S Afr J Surg, 2021.PMID 34212569
- [18]Rai A, et al. Study of Diagnostic Delay among Symptomatic Breast Cancer Patients in Northern India Asian Pac J Cancer Prev, 2022.PMID 35345361
- [19]Zhang M, et al. Imaging and Management of Fibroepithelial Lesions of the Breast: Radiologic-Pathologic Correlation Radiographics, 2023.PMID 37856317
- [20]Gil Quessep E, et al. Subgroups varying in risk and density highlight the potential for stratified breast cancer screening Eur J Cancer, 2025.PMID 39805236
- [21]More RS, et al. Efficacy of Modified Triple Assessment in Diagnosing Breast Lesions: A Prospective Observational Study Cureus, 2025.PMID 40314043
- [22]Ahire P, et al. Unraveling Benign Breast Conditions: A Comprehensive Study of Diagnosis, Treatment, and Care Cureus, 2025.PMID 40600088
- [23]Jansen C, et al. Surgical treatment of breast fibroadenomas Dan Med J, 2025.PMID 41069312
- [24]Moshina N, et al. Breast cancer mortality among women who have attended BreastScreen Norway, 1996-2023 Breast Cancer Res, 2026.PMID 41845512
- [25]Pestrin O, et al. A longitudinal observational study of male referrals and adherence to imaging guidelines Front Oncol, 2026.PMID 42022318
- [26]Scardina L, et al. Management of lactational and non-lactational breast abscesses: an evidence-based framework Updates Surg, 2026.PMID 42334816
- [27]Zhong W, et al. Clinical factors of prolonged treatment duration in patients with non-puerperal mastitis Gland Surg, 2026.PMID 42445087
- [28]Boldrini C, et al. The Gems and Pitfalls of Inflammatory Breast Disease: An Illustrated Review of Mastitis Radiol Res Pract, 2026.PMID 42540206