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.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network

Exclusions

  • cosmetic breast augmentation including replacement of breast implants for cosmetic purposes

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • suspected breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)
  • new breast cancer diagnosis seeking immediate reconstruction
  • patients requiring mastectomy who wish to discuss breast reconstruction prior to surgery

Category 2 — appointment clinically indicated within 90 days

  • established mastectomy for delayed reconstruction
  • developmental breast anomalies including breast asymmetry
  • genetic high risk/family history of breast cancer
  • partial mastectomy for reconstruction or contralateral balancing procedures
  • post mastectomy breast reconstruction breast implant exchange for medical reasons
  • removal of augmentation breast implant/s for medical reasons
  • miscellaneous breast cancer related problems

Category 3 — appointment clinically indicated within 365 days

  • post mastectomy breast reconstruction breast implant exchange without evidence of rupture
  • consideration of previous breast reconstruction revision

For more on outpatient referrals, see the general referral information.

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.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical history
  • history of previous breast surgery or breast cancer related treatment and dates/years of treatment
  • current medications and dosages
  • allergies and sensitivities
  • smoking/vaping status
  • presenting symptoms
  • management history including:
    • onset and duration
    • pain/discomfort
    • severity of symptoms
    • associated features, e.g. functional impairment, emotional distress
    • impact on activities of daily living/ability to care for others
    • treatments trialled/implemented prior to referral
  • relevant investigations and reports (please include provider details and accession number)

Additional information to assist triage categorisation

  • details of implants associated with previous breast surgery

Clinical management advice

Ruptured or painful breast implants can be removed in the public system. Replacement of breast implants will only be done if original implant was for reconstructive purposes.

If the patient requires urgent attention and/or fulfils category 1 triage criteria, please contact the on-call registrar to discuss and ensure your referral has been received.

Clinical resources

Consumer resources