Information for GPs

Breast Cancer

screening & surveilance

  • Pre-Diagnosis.

    Frontline screening (Breast Screen WA) & early detection.

    Referral for screening & genetic testing in high-risk patients. 

  • Risk Factors.

    Age > 50 years

    Family history of breast/ovarian cancer

    Genetic mutations (e.g., BRCA1, BRCA2)

    Hormonal factors (early menarche, late menopause, HRT use)

    Lifestyle factors (obesity, alcohol consumption, physical inactivity) 

  • Symptoms and Signs.

    Breast lump (painless or painful)

    Nipple discharge (bloody or clear)

    Skin changes (dimpling, redness, ulceration)

    Nipple retraction or inversion

    Axillary lymphadenopathy 

  • Screening and Diagnosis.

    Mammogram : Recommended every 2 years for women aged 50-74; consider earlier for high-risk groups.

    Ultrasound : For younger women (< 40 years) or to assess abnormalities on mammogram.

    Biopsy : Core needle biopsy for histopathological confirmation. 

  • Role in Ongoing Care.

    Post-treatment surveillance: Monitor for recurrence with regular breast exams and imaging as per specialist recommendations.

    Manage treatment side effects: Address lymphoedema (refer to OT), menopausal symptoms, bone health, and cardiotoxicity risks.

    Psychosocial support: Assist with mental health, body image concerns, and support group referrals.

    Lifestyle advice: Encourage healthy diet, regular exercise, and alcohol reduction/smoking cessation. 

  • Red Flags for Recurrence or Metastasis.

    New breast lump or skin/nipple changes

    Persistent bone pain

    Unexplained weight loss

    Persistent cough or breathlessness

    Neurological symptoms (headaches, seizures)

About Breast Cancer

  • Referral Guidelines

    Key details for surgeon referral:

    Clinical findings & imaging results

    MMG & US report

    Biopsy reports – full report with receptor status

    Any significant medical history & medications

    Stagings scan, MRI etc - not necessary 

  • Case Scenarios

    New breast Lump → Triple assessment (clinical exam, imaging, biopsy) → Specialist referral if malignant or suspicious/indeterminate.

    Dense Breast on screening mammogram → Consider ultrasound ± triple assessment.

    Family History concern → Assess risk with CanRisk or iPrevent, refer for genetic counselling if high risk. More information on eVIQ website

    Post-Treatment follow up → Annual MMG, monitor for systemic symptoms, bone density (if on aromatase inhibitor), lifestyle modification

    Social Challenges → Support services (Cancer Council, BCCWA, BCNA, Surgeon, Breast Care Nurse) 

  • Resources for GPs and Patients

    Cancer Council WA: www.cancerwa.asn.au

    Breast Cancer Care WA: www.breastcancer.org.au

    National Breast Network Australia: www.bcna.org.au

    Allocated Breast Care Nurse

    Local breast cancer support services and specialist referral pathways

The information provided is intended as guidelines only and should not be considered as definitive advice. It is recommended to consult relevant experts or authorities for specific guidance tailored to individual circumstances.