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.

  • post operative breast surgery presentation with following symptoms:
    • acute haematoma
    • venous congestion of the nipple, contact surgical team and instruct patient to remain fasting until reviewed in the emergency department

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

Central Adelaide Local Health Network (CALHN):

  • body mass index (BMI) greater than or equal to 35kg/m2
  • active smokers/vapers

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • nil

Category 2 — appointment clinically indicated within 90 days

  • nil

Category 3 — appointment clinically indicated within 365 days

  • macromastia
  • breast implant for removal

For information on referral forms and how to import them, please view 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
  • identify within your referral 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
  • history of surgery/chemotherapy/radiotherapy in breast cancer patients
  • ultrasound with or without aspirate of seroma surrounding breast implant if relevant
  • current medications and dosages
  • allergies and sensitivities
  • smoking/vaping status
  • stable weight (variation within 5 kilograms) for at least 12 months post bariatric surgery
  • body mass index (BMI)
  • presenting symptoms including any two or more of the following:
    • demonstrable recurrent skin irritations, intertrigo in the inframammary fold and rashes that have been resistant to medical management with topical treatments and antibiotics over a six-month period
    • demonstrable indentations of the shoulders from the bra straps that support heavy pendulous breasts
    • acquired thoracic kyphosis
    • chronic breast pain, headaches, paraesthesia of the upper extremity
    • the patient’s breast size limits physical activity
    • the patient is emotionally and socially bothered with large breasts with resultant low self-esteem and episodes of documented depression
  • relevant investigations and reports, include provider details and accession number

Additional information to assist triage categorisation

Additional referral criteria for Central Adelaide Local Health Network (CALHN):

Clinical management advice

Breast reduction surgery is offered to people who have symptoms including skin rashes and infections, back/neck pain, psychological impact, and exercise limitation, secondary to breast size that adversely effects quality of life.

Ruptured or painful breast implants can be removed, but not replaced unless the primary reason for augmentation was reconstructive.

Breast reduction will be considered when breast size is not attributable to excess weight and when a substantial health benefit can be expected.

Order baseline mammogram over 40 years of age. Consider best imaging modality if less than 40 years of age with a strong family history of breast cancer.

It is strongly recommended that people who smoke or vape stop 3 months prior to consultation. Smoking/vaping is associated with delayed healing. Please refer to useful resources section for further information.

Patients with body mass index (BMI) greater than or equal to 35 should be counselled around weight loss management. Please refer to useful resources section for further information.

Plastic and Reconstructive surgery service in South Australia have different thresholds for treatment and assessment related to the body mass index. Please ensure you are aware of these prior to referring for assessment.

People who have had massive weight loss must also meet the essential referral criteria for assessment.

Clinical resources

Consumer resources