Breast Clinic Referrals
The RPH Breast Clinic multidisciplinary team provides comprehensive services for the assessment and management of benign and malignant breast conditions.
Imaging and pathology results must accompany Royal Perth Hospital (RPH) Breast Clinic referrals to ensure referral acceptance and urgency triaging.
A complete work up of breast lumps prior to surgical review includes the triple assessment:
- Physical examination
- Mammogram and ultrasound of breasts and axilla are required for baseline imaging of suspected breast cancers
- Core biopsy of the breast lesions(s) is preferred to find needle aspiration (FNA).
Services
- Diagnostic service including mammography, ultrasound and imaging guided biopsy, for breast lumps
- Breast surgery for management of breast cancer and benign breast conditions where indicated
- Assessment and management of benign breast conditions
- Specialist breast care nurse support
- Clinical psychology service for women with breast cancer
- Physiotherapy including a lymphoedema prevention program
- Familial High-risk clinic for women with significant family history of breast cancer / genetic mutation
Immediate transfer to the Emergency Department if the following condition is present or suspected, phone 000 to arrange immediate transfer to the Emergency Department or seek emergent advice if in a remote area.
- Breast abscess
Arranging urgent review or advice.
To arrange an urgent review or advice, please phone the RPH switchboard on 9224 2244 and if Monday to Friday 8:00 am to 5:00 pm, ask to speak with Breast Surgery Registrar or Fellow, or if after hours, the General Surgical Registrar on call.
After verbal clinical handover and agreement with the registrar that the patient requires an appointment with RPH within 7 days please send the immediate referral to:
- rphbhref via HealthLink (preferred)
- or by email to the patient's referral to RPH.OutpatientReferrals@health.wa.gov.au
Ensure the referral is:
- marked IMMEDIATE
- the name of the registrar or consultant spoken with is written on the referral
- all essential referral information, investigations, clinical photos are included
Immediate referrals (requiring an appointment within 7 days) include:
- Inflammatory breast cancer
- Breast abscess via the Emergency Department
- Breast cancer in pregnancy
- Rapidly progressing breast disease
Please refer to Clinician Assist WA: Breast symptoms for more information
Referrals are triaged based on clinical priority. The RPH Breast clinic manages the following conditions:
Urgent: Appointment within 30 days (Category 1)
- Malignant diagnosis biopsy proven
- Imaging suggestive malignancy
- Clinically suspicious
- New lump no work up
- Bloody nipple discharge
- Nipple changes; rash, recent inversion or retraction
- Metastatic breast disease
- Indeterminate lesion
- Suspected BIA-ALCL
SEMI-URGENT: Appointment within 90 days (Category 2)
- Mixed epithelial and connective tissue breast disease such as fibroadenoma >3cm, fibrocystic breast disease
- New or recurrent mastalgia with indeterminate imaging
- New discrete lump without suspicious features
- Complex cyst
Routine: Appointment within 365 days (Category 3)
- Suspected high-risk patients, for familial breast cancer
- Diagnosed benign breast lumps
- Breast implant rupture without any concerning features for cancer of ALCL
Essential referral information (referrals will be returned without this)
- Mammogram, ultrasound and pathology reports including receptor status (if available).
- If unable to attach reports, please paste the results into the body of the referral and include investigation date(s) and facilities where investigations were performed.
- If additional results are received after the referral has been sent, send via:
- HealthLink rphbhref (preferred)
- Email: RPH.OutpatientReferrals@health.wa.gov.au
If referring from a country area with no imaging or pathology services available, or where imaging is available, but the patient cannot afford it, please state this on the referral.
Minimum standard referral is included in the standard referral template referral for templates and is available minimum standards for outpatient referrals central referral service
Please ensure patient email and mobile phone numbers are included to facilitate patient contact.
Additional Referral information
Please note: breast clinic has an extensive outpatient waitlist for routine referrals
Consider alternate referral pathways such as:
- Ensuring full condition clinical pathways have been explored via Clinician Assist WA: Breast Symptoms
- Review our full list of specialists
- Referral to private or community provider
After triaging for urgency, breast clinic referrals will be allocated to a suitably qualified specialist to see the patient, booked based on first on, first off principals from the outpatient waitlist.
Referring to Breast Clinic without naming a consultant allows the referral to be allocated to any suitable qualified specialist within the speciality so that your patient receives the first available appointment for their clinical triage urgency (Urgent, Semi-Urgent, Routine).
Referrals to named consultants follow these same booking principles however as they are limited to only one consultant’s clinic, patients often end up waiting longer to be seen as some RPBG consultants only provide a fortnightly or monthly clinic.
However, if you have discussed a case with a particular consultant or registrar, please include the name of the doctor you spoke with on the referral.
The following are not routinely provided in a public Breast Clinic service:
- Patients outside of the East Metropolitan Health Service (EMHS) and WA Country Health Service (WACHS) catchment area.
- Patients from Private Breast Specialists for ongoing routine follow up mammograms following surgery in the private sector.
- Routine screening – please direct these requests to BreastScreen WA or privately.
EMHS is responsible for providing public health services to the people who reside within its boundaries.
The catchment map (PDF 400KB) outlines the suburb catchment areas for East Metropolitan Health Service (EMHS). The country areas that flow to EMHS are Kimberley, Pilbara and Wheatbelt.
Referral to a hospital for assessment and/or treatment is based around multiple criteria. These include:
- Place of residence – most hospitals have catchments to help service people closer to home. For country patients, the residence of family with whom they will reside whilst attending appointments can be taken into consideration.
- Age – RPH is an Adult Hospital, children are only treated by some hospitals.
- Hospital location of specialty services – some conditions need designated specialist services that are not available at all hospitals.
Please use this information to guide referrals to the hospital servicing your patient's residence and inform your patients of these criteria when you are referring them for public hospital services via the Central Referral Service (CRS).