Speciality: General surgery
Age group: Adult
Direct to an emergency department for:
- Breast abscess failing drainage
- Lactational mastitis with systemic symptoms.
Criteria for referral to public hospital service
- New palpable and persistent cyst(s) with complex features on imaging
- Recurrent cyst(s) with complex features on imaging
- Palpable, symptomatic, or growing fibroadenoma
- Any one component of the triple test is positive (clinical examination, imaging or non-excisional biopsy)
- Incomplete cyst aspiration, bloody aspirate (not traumatic) or a lump that remains post-aspiration
- Spontaneous unilateral, bloody or serous discharge from a single duct, particularly if older than 60 years
- Eczematoid changes of the nipple-areolar skin for longer than 2 weeks that fails to respond to topical treatment
- Inflammatory breast conditions not resolving after 2 weeks of antibiotic treatment.
Information to be included in the referral
Information that must be provided
- Most recent mammography report or other breast imaging report(s) including when and where imaging was performed
- Findings on physical examination
- Details of previous medical management including the course of treatment and outcome of treatment
- Relevant medical history and comorbidities
- Any family history or genetic mutation linked to breast, ovarian or prostate cancer.
Provide if available
- Core biopsy findings (location, size, type, histological grade and lymph node status) or fine needle aspiration (FNA) cytology results
- Breast density
- 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/or 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.
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
- Single or multiple simple cysts
- Fibrocystic breasts
- Breast pain with normal imaging and clinical examination
- No significant abnormality or benign findings on biopsy or imaging or both.
Reviewed 27 May 2025