2.3 Initial referral

2.3 Initial referral

Any patient with symptoms suspicious of breast cancer can be referred for specialist assessment as first line. If the diagnosis of breast malignancy is confirmed or the results are inconsistent or indeterminate, referral to a BreastSurgANZ member breast surgeon is warranted. See BreastSurgANZ ‘Find a surgeon’ for a directory.

Patients should be enabled to make informed decisions about their choice of specialist and health service. General practitioners should make referrals in consultation with the patient after considering the clinical care needed, cost implications (see referral options and informed financial consent), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.

Referral for suspected or diagnosed breast cancer should include the following essential information to accurately triage and categorise the level of clinical urgency:

  • important psychosocial history and relevant medical history
  • family history, current symptoms, medications and allergies
  • results of current clinical investigations (imaging and pathology reports with ER, PR and HER2 receptor profile)
  • results of all prior relevant investigations
  • notification if an interpreter service is required.

Many services will reject incomplete referrals, so it is important that referrals comply with all relevant health service criteria.

If access is via online referral, a lack of a hard copy should not delay referral.

The specialist should provide timely communication to the general practitioner about the consultation and should notify the general practitioner if the patient does not attend appointments.

Aboriginal and Torres Strait Islander patients will need a culturally appropriate referral. To view the optimal care pathway for Aboriginal and Torres Strait Islander people and the corresponding quick reference guide, visit the Cancer Australia website. Download the consumer resources Checking for cancer and Cancer from the Cancer Australia website.

A positive result on any component of the triple test warrants specialist surgical referral. Ideally, the surgeon should see the patient with proven or suspected cancer within two weeks of diagnosis. If necessary, prior discussion should facilitate referral.