We acknowledge the Traditional Owners of Country throughout Australia and their continuing connection to the land, sea and community. We pay our respects to them and their cultures and to Elders past, present and emerging.

This work is available from the Cancer Council website.

First published in September 2015. This edition published in June 2021.

ISBN: 978-1-76096-149-7

Cancer Council Victoria and Department of Health Victoria 2021 Optimal care pathway for people with breast cancer, 2nd edn, Cancer Council Victoria, Melbourne.

Enquiries about this publication can be sent to optimalcare.pathways@cancervic.org.au.

Our thanks to the following health professionals, consumer representatives, stakeholders and organisations consulted in developing this optimal care pathway.

Professor Christobel Saunders (Chair), Surgeon, Royal Perth Hospital, Fiona Stanley Hospital, St John of God Subiaco Hospital; Professor Surgical Oncology, The University of Western Australia; Chair, PathWest Laboratory Medicine

Professor Fran Boyle, Medical Oncologist, Mater Hospital

Dr Adrian Dabscheck, Palliative Care Physician, Western Health

Dr Bianca Devitt, Medical Oncologist, Eastern Health

Miss Gillian Farrell, Plastic Surgeon, Cabrini Health

Professor Gelareh Farshid, Senior Consultant Pathologist; SA Pathology, Royal Adelaide Hospital

Dr Jocelyn Lippey, Surgeon, St Vincent’s Hospital Melbourne and Northern Hospital

Professor Bruce Mann, Surgeon, The Royal Melbourne Hospital, The Royal Women’s Hospital and Peter MacCallum Cancer Centre

Professor Kelly-Anne Phillips, Medical Oncologist, Peter MacCallum Cancer Centre

Ms Kirsten Pilatti, Chief Executive Officer, Breast Cancer Network Australia

Ms Lisa Sheeran, Breast Care Nurse Consultant, Peter MacCallum Cancer Centre

Ms Danielle Spence, Head of Division, Strategy and Support, Cancer Council Victoria

Professor Robert Thomas, Special Advisor on Health, Professorial Fellow, The University of Melbourne

Dr Alison Trainer, Clinical Geneticist, Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital

Dr Yvonne Zissiadis, Radiation Oncologist, Genesis Care

Ms Julia Brancato, Project Coordinator, Optimal Care Pathways, Cancer Council Victoria

Professor Christobel Saunders, Surgeon (Chair), Royal Perth Hospital, Fiona Stanley Hospital, The University of Western Australia

Associate Professor Boon Chua, Radiation Oncologist, Peter MacCallum Cancer Centre

Associate Professor Jacquie Chirgwin, Medical Oncologist, Box Hill Hospital; Director, ANZ Breast Cancer Trials Group

Ms Linda Cicciarelli, Genetic Counsellor, Peter MacCallum Cancer Centre

Dr Adrian Dabscheck, Palliative Care Physician, Western Health

Miss Gillian Farrell, Plastic Surgeon, Cabrini Health

Associate Professor Gelareh Farshid, Pathologist; Clinical Director, BreastScreen SA

Ms Jane Fletcher, Health Psychologist, Cabrini Health; Director, Melbourne Psycho-oncology Service

Ms Coral Keren, consumer representative

Professor Bruce Mann, Surgeon, The Royal Melbourne Hospital, The Royal Women’s Hospital and Peter MacCallum Cancer Centre

Ms Sarah Pratt, Breast Care Nurse, Peter MacCallum Cancer Centre

Professor Kelly-Anne Phillips, Medical Oncologist, Peter MacCallum Cancer Centre

Professor Gary Richardson, Medical Oncologist, Cabrini Health

Dr Liu-Ming Schmidt, Surgeon, Albury Surgical Group

Ms Wanda Stelmach, General and Breast Surgeon; Clinical Program Director, Surgery, Northern Health

Dr Karen Taylor, Senior Specialist Radiation Oncologist, William Buckland Radiotherapy Centre, The Alfred, Cabrini Health

Mr Peter Thomas, General and Breast Surgeon, Wangaratta

Dr John Waugh, Radiologist, Director of Training, Monash BreastScreen

Professor Robert Thomas, Chief Advisor on Cancer, Department of Health and Human Services, Victoria

Advance Care Planning Australia

Allied Health Professions Australia

Australasian Association of Nuclear Medicine Specialists

Australasian Chapter of Palliative Medicine, Royal Australia College of Physicians

Australasian Lymphology Association

Australian and New Zealand Society of Neuroradiology

Australian and New Zealand Society of Palliative Care

Australian Cancer Survivorship Centre

Australian College of Nursing

Australian Medical Association

Australian Society of Medical Imaging and Radiation Therapy

Breast Cancer Network Australia

Breast Screen Victoria

Cancer Nurses Society of Australia

Clinical Oncology Society of Australia

Counterpart

Interventional Radiology Society of Australasia

Medical Oncology Group of Australia

McGrath Foundation

National Breast Cancer Foundation

Oncology Social Workers Australia and New Zealand

Royal Australasian College of Physicians

Royal Australasian College of Surgeons

Royal Australian and New Zealand College of Radiologists

Royal Australian College of General Practitioners

Royal College of Pathologists of Australasia

Alfred Health

Cancer Australia

Cancer Council Victoria, Strategy and Support Division

Cancer Institute New South Wales

Concord Repatriation General Hospital New South Wales

Consumer representative

Department of Health Victoria, Commissioning and System Improvement Division, Cancer Unit

National Cancer Expert Reference Group

Olivia Newton-John Cancer Wellness and Research Centre

St Vincent’s Hospital Melbourne

Other stakeholders consulted to provide feedback include relevant Cancer Council committees and networks, Integrated Cancer Services, Primary Health Networks and several health services.

The multidisciplinary team should include the following members:

• breast surgeon
• medical oncologist
• nurse(s) (with appropriate expertise such as a breast care nurse)
• pathologist
• radiation oncologist
• radiologist.

The multidisciplinary team may include the following members:

• Aboriginal health practitioner, Indigenous liaison officer or remote general practitioner
• care coordinator
• clinical trial nurse/coordinator
• dietitian
• exercise physiologist
• fertility specialist
• general practitioner
• geneticist and/or genetic counsellor
• lymphoedema physiotherapist/specialist
• occupational therapist
• pain specialist
• palliative care specialist
• pharmacist
• physiotherapist
• plastic surgeon
• psychologist
• psychiatrist
• reconstructive surgeon
• social worker
• spiritual/pastoral care.