Clinical Lead - Dr Christopher Allen
This page contains information for general practitioners on how to refer patients aged 16 years and over to General Surgery – Breast and Endocrine services at Mater Hospital Brisbane
Service Availability:
The Breast and Endocrine service accepts referrals from GPs and specialist services.
Catchment criteria applies for referrals for this service. Patient referrals from outside the Mater SEQ Catchment (which includes Metro South and West Moreton Hospital and Health Services) may not be accepted.
The Breast Surgery service consists of surgeons, clinical nurses and two accredited Breast Care Nurses. The Breast Care Nurses provide tailored information and psychosocial support to patients with Breast Cancer with face-to-face clinics and telephone support. Patients also have access to allied health services including physiotherapy, psychology, social work, occupational therapy and dietetics.
The Breast and Endocrine service integrates with other specialties including Medical and Radiation Oncologists, Pathologists and Research Staff at weekly multidisciplinary team meetings to establish individualised plans of care.
The Breast and Endocrine Surgery service consistently review patients within recommended OPD categorisation times.
Please note for patients who require a referral for breast reconstruction please send a named referral to the Plastic Surgery Service.
Emergency care
If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergency medical advice if in a remote region:
- Acute abscess at any site
Bulk Billed Clinics
Mater Health Services offers patients the opportunity to attend bulk billed clinics. To provide your patient with the opportunity to attend a bulk billed specialist clinic, please provide a named referral to one of our specialists listed above.
Current Waiting Time for Appointments
We provide up to date data on how long patients are waiting for their first appointment by specialty here.
Referral Guideline Development
These Mater Referral Guidelines align with standardised best practice tools for referral to publicly funded specialist outpatient services developed in Queensland through the Clinical Prioritisation Criteria project.
Contact us
If you would like to discuss a referral, including clinical criteria, or update the status of a current patient please contact our priority GP phone line on 07 3163 2200
Conditions in scope
Breast surgery - benign and malignant
Essential information (Referral will be declined without this)
- General 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
Additional referral information (useful for processing the referral)
- Staging investigations e.g. Bone scan, CT scan
Other useful information for management (not an exhaustive list)
- 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
- Consider referral to Geneticist for familial genetic screening if appropriate
- Discuss lifestyle modifications for cancer reduction risk (increased activity, dietary, weight, smoking, alcohol)
- Aboriginal and/or Torres Strait Islander people support services for breast cancer are available
- 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/
- Guide for investigation of a breast lump - Triage process for presentation with no family or past history. Adaption from general surgery review process CDHB 2001. http://www.baysidehealth.org.au/Assets/Files/GP_Referral_BES.pdf
Categorisation
Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.
Category 1 – urgent Clinically recommended timeframe for initial appointment is 30 days | Category 2 - Priority Clinically recommended timeframe for initial appointment is 90 days | Category 3 - Routine Clinically recommended timeframe for initial appointment is 365 days |
Diagnosed breast cancer:
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 Ductal papilloma 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 | Benign breast disease for consultation Low-risk breast lumps/cysts Patient referred for screening for breast malignancy or prophylactic mastectomy 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 breast tenderness and where breast size is disproportionate to body habitus | Gynaecomastia Prophylactic mastectomy |
Endocrine surgery
Essential information (Referral will be declined without this)
- General referral information
- Thyroid – USS +/- FNA TFT and CXR results
- Adrenal – CT scan results
- Parathyroid – corrected calcium, PTH results, 24 hour urinary calcium estimation, neck ultrasound
Additional referral information (useful for processing the referral)
- Sestamibi scan reports for parathyroid (if available)
- Adrenal – eLFT, Renin: Aldosterone Ratio, Plasma Metanephrines, Cortisol
Other useful information for management (not an exhaustive list)
- Refer to HealthPathways or local guidelines
- Tirads, Bethesda cytology if available
Categorisation
Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.
Category 1 – urgent Clinically recommended timeframe for initial appointment is 30 days | Category 2 - Priority Clinically recommended timeframe for initial appointment is 90 days | Category 3 - Routine Clinically recommended timeframe for initial appointment is 365 days |
|
|
|
Other breast and endocrine surgery conditions
Essential information (Referral will be declined without this)
- General Referral Information
- Relevant condition information
- Relevant pathology and imaging reports
Categorisation
Available appointments are provided to our patients based on clinical priority. A process of categorisation ensures safety and equity of access.
Category 1 – urgent Clinically recommended timeframe for initial appointment is 30 days | Category 2 - Priority Clinically recommended timeframe for initial appointment is 90 days | Category 3 - Routine Clinically recommended timeframe for initial appointment is 365 days
|
Conditions not in scope
Non-routine conditions
The following conditions are not routinely provided at Mater Hospital Brisbane:
- Aesthetic or cosmetic surgery
- Breast reduction/augmentation
- Appearance medicine
Medical imaging referrals
GPs can refer patients directly to Queensland X-Ray's Mater Hospital Brisbane (MHB) radiology department for relevant investigations. If the imaging request is for FNA or core biopsy, a pathology request form is also required.
Queensland X-Ray will accept requests on any medical imaging request form or letterhead.
P: 07 3212 9000
F: 07 3163 1850
Please note: in these cases this referral to Queensland X-Ray:
- Does not constitute a referral to the Breast and Endocrine service.
- The referring GP is responsible for checking and acting upon the result of the investigation.
- Queensland X-Ray is independent to Mater, and patients may incur a fee for service for direct referrals not directly linked to a valid public hospital referral.