2.2 Assessments by the general practitioner
General practitioner examinations and investigations may include (but should not delay specialist assessment):
- structural imaging with ultrasound, CT and/or MRI
- ultrasound-guided fine-needle aspiration cytology (USgFNAC) of a node, if malignancy is suspected or a neck lump persists or grows (including lumps in the thyroid, salivary gland or lymph node).
Excisional biopsy of potentially malignant lesions should not be undertaken. Appropriately trained practitioners can consider biopsy of a primary site but this should not delay referral. Lymph nodes should not have incisional or excisional biopsy without specialist input.
Signs and symptoms (listed in 2.1) should be investigated if they persist for more than three weeks, especially if more than one symptom is present.