Breast – benign and malignant

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Useful Management Information

USS both breast if:
- <35 years old with:
  - breast lump or thickening or axillary mass
  - if a localised abnormality or suspicious lesion proceed to FNAB or core biopsy
Bilateral mammogram and USS if:
- >35 years old with significant breast symptoms or significant clinical findings
If patient is considering familial genetic screening, referral can be made to the Breast Screen Breast Cancer Family Clinic
Aboriginal and/or Torres Strait Islander people support services for breast cancer are available

Clinican Resources

Best practice information on breast cancer - Cancer Australia, Clinical Best Practice, Breast Cancer
GP guides and resources for breast cancer https://canceraustralia.gov.au/clinical-best-practice/breast-cancer/gp-guides-and-resources
Cancer risk reduction – https://canceraustralia.gov.au/healthy-living/lifestyle-risk-reduction
Familial risk assessment tool – http://canceraustralia.gov.au/clinical-best-practice/gynaecological-cancers/fra-boc/evaluate
Information on genetic testing – http://canceraustralia.gov.au/clinical-best-practice/gynaecological-cancers/familial-risk-assessment-fra-boc/genetic-testing
The BreastScreen program – 50-74 years – is funded to investigate asymptomatic patients only to the point of clear diagnosis (accepts woman in their 40s or 75 years and over).
http://www.health.qld.gov.au/breastscreen/

Minimum Referral Criteria

Category 1	Diagnosed breast cancer: early (confined to breast) locally advanced (spread to involve areas near the breast) secondary spread (involving areas outside the breast e.g. lymph node Inflammatory breast cancer (rare, involves lymphatic spread causing inflammation in the breast) Recurrent breast malignancy Suspicious lesion on breast screening mammography or FNAC Suspicious breast mass on clinical examination Ductal carcinoma-in-situ (non-invasive confined to the ducts) Lobular carcinoma-in-situ (non-invasive confined to lobules) Breast lump New diagnosis or clinically suspicious of primary breast malignancy (biopsy or mammogram proven) New discrete lump Young women with tender, lumpy breasts Asymmetrical nodules that persist at review after menstruation Older women with symmetrical nodules provided that they have no localised abnormality Any lump that increases in size Cyst persistently refilling or recurrent cyst New lump during pregnancy Breast pain Continuous mastalgia Localised areas of painful nodularity/ focal lesions Nipple discharge, nipple retraction, change in skin contour Discharge sufficient to stain clothes Blood stained discharge Persistent single duct Nipple retraction/distortion Nipple eczema Paget's disease of the nipple
Category 2	Benign breast disease for consultation Low-risk breast lumps/cysts Nipple discharge (non-blood stained) Ductal papilloma Fibroadenoma (diagnostic excision biopsy if diagnostic uncertainty) Intermittent mastalgia i.e. hormonal Gynaecomastia where there is substantial breast enlargement or significant breast tenderness and where breast size is disproportionate to body habitus
Category 3	Gynaecomastia Prophylactic mastectomy
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Document details/duration symptoms
Document family history of breast cancer
Description of clinical findings
Medical management to date
Current USS/mammography results
Current FNAC or core biopsy results
Any previous relevant investigation results
Gynaecomastia require BMI

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

No additional referral information

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Breast Surgery (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.