Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • metastatic breast cancer with uncontrolled pain
  • breast abscess not responding to radiological drainage, threatened skin integrity or associated systemic symptoms

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Regional Health Networks 

Barossa Hills Fleurieu Local Health Network

Eyre and Far North Local Health Network

Flinders and Upper North Local Health Network

Limestone Coast Local Health Network

Riverland Mallee Coorong Local Health Network

Yorke and Northern Local Health Network

Inclusions

  • new palpable and persistent lumps/cysts with complex features on imaging
  • any previously diagnosed lump/mass that increases in size or imaging changes
  • new lump during pregnancy
  • palpable, symptomatic, or growing fibroadenoma
  • any one component of the triple test is positive, clinical examination, imaging or non-excisional biopsy
  • breast lump with non-diagnostic biopsy with persisting symptoms/imaging abnormality.
  • inflammatory breast conditions with negative imaging not resolving after two weeks of anti-biotic treatment

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • confirmed or suspected breast cancer on imaging
  • abscess failing conservative treatment

Category 2 (appointment clinically indicated within 90 days)

  • benign breast lumps, e.g. fibroadenoma
  • new lumps with non-suspicious features
  • cyst persistently refilling or recurrent cyst
  • asymmetrical nodularity that persists at review after menstruation

Category 3 (appointment clinically indicated within 365 days)

  • nil

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • past medical history
  • details of previous medical management including the course of treatment and outcome of treatment.
  • any family history or genetic mutation linked to breast, ovarian or prostate cancer.
  • details of presenting complaint e.g. duration of symptoms
  • if confirmed cancer, provide relevant reports – including provider details. e.g.histopathology, imaging, particularly Breast Screen SA report
  • most recent mammography report or other breast imaging report(s) including when and where imaging was performed

Additional information to assist triage categorisation

  • any specific clinic requirements e.g. significant limitations to mobility, severe anxiety relating to hospitals/needles
  • medication list
  • menopause status
  • body mass index (BMI)
  • family history

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • full name, including aliases
  • date of birth
  • residential and postal address
  • telephone contact number/s – home, mobile and alternative
  • Medicare number, where eligible
  • name of the parent or caregiver, if appropriate
  • preferred language and interpreter requirements
  • identifies as Aboriginal and/or Torres Strait Islander

Clinical modifiers

  • impact on employment
  • impact on education
  • impact on home
  • impact on activities of daily living
  • impact on ability to care for others
  • impact on personal frailty or safety
  • identifies as Aboriginal and/or Torres Strait Islander

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.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.