Breast Surgery Clinic

Scope:

• To evaluate and treat newly diagnosed breast cancer patients.
• To provide consultation and care that is beyond the routine abilities of the primary care physicians.

Appropriate patients for referral include:

• Positive pathology per biopsy
• Obvious tumor growth by exam (nipple inversion, dimpling, peau d ‘orange, ulceration)
• Bloody nipple discharge
• Fibro adenomas over 2 cm
• BRCA positive patients
• Abscess unresolved by full course of antibiotics
• BIRADS 3, 4, and 5 Mammogram and US (please see additional information under breast mass below)
• Breast Papilloma’s
• Paget’s disease
• Atypical Hyperplasia

Please do NOT refer the following patients:

• Fibro adenomas under 2 cm
• Breast Cyst
• Breast pain
• Benign masses diagnosed by pathology
• Extra breast tissue
• Extra nipple
• Nipple discharge with abnormal prolactin levels
• High risk patients for BRCA testing (please refer to the Myriad website for assistance)
• Mastitis
• Breast mass on exam but normal imaging (BRADS 1-2). Recommendation: Repeat imaging as suggested by radiology along with clinical breast exam. Consider ultrasound guided biopsy if clinically indicated.
• Axillary mass with normal breast imaging

Documentation required for scheduling all appointments:

• Completed referral form
• Mammogram or ultrasound within the past 3 months
• History and Physical
• Current medications

Breast Mass

• If Mammogram or ultrasound suggests biopsy, please obtain biopsy and refer with FINAL pathology report. For microcalcifications, order stereotactic biopsy. For breast mass, order ultrasound guided biopsy. To schedule either of these at a Seton facility call Central Scheduling at 512-324-1199.

Nipple Discharge

• Serum Prolactin level
• cytology of nipple discharge

BRCA positive patients

• BRCA results
• Any surgical reports related to BRCA results (mastectomy/oopherectomy)

Revised May 2015

Have questions or comments about the specialty referral guidelines? Submit them here.