Direct to an emergency department for: 

  • Metastatic breast disease with intractable pain
  • Fungating mass with haemorrhage
  • Post-surgical wound with dehiscence or sepsis

Criteria for referral to public hospital service

  • Core biopsy with suspicious or equivocal findings or proven breast cancer (e.g. detected through BreastScreen Australia Program)
  • Malignant, suspicious or equivocal findings on imaging
  • Clinical findings suspicious of malignancy.

Information to be included in the referral

Information that must be provided

  • Provide core biopsy findings (location, size, type, histological grade and lymph node status). Where a core biopsy was not possible provide fine needle aspiration (FNA) cytology results
  • Most recent mammography report (if > 35 years) or other breast imaging report(s) including when and where imaging was performed
  • Findings on physical examination
  • Relevant medical history and comorbidities (e.g. past history of breast disease or breast cancer, ductal carcinoma in situ)
  • Details of any breast implant(s) including when and where procedure(s) was performed
  • Any family history or genetic mutation linked to breast, ovarian or prostate cancer.

Provide if available

  • Current and complete medication history (including hormonal treatments, non-prescription medicines, herbs and supplements and recreational or injectable drugs)
  • Comprehensive past medical history
  • Details of any current issues that may impact on the person’s ability to attend a specialist clinic appointment
  • If the person identifies as an Aboriginal and Torres Strait Islander
  • If the person is part of a vulnerable population.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Biopsy is not required prior to referral for suspicious findings of malignancy or malignant findings on imaging.

Where a non-excisional biopsy is performed, core biopsy is preferable for the investigation of suspicious lesions. FNA cytology results may be used under limited circumstances where a core biopsy was not possible.

Vulnerable populations include:

  • people from culturally and linguistically diverse backgrounds
  • older Australians
  • carers of people with chronic conditions
  • people experiencing socio-economic disadvantage
  • people living in remote, or rural and regional locations
  • people with a disability
  • people with mental illness
  • people who are, or have been, incarcerated.

Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.

Referral to a public hospital is not appropriate for

  • No significant abnormality detected
  • Benign or indeterminate findings on imaging.