Information for General Practitioners
Breast Cancer is the most common cause of cancer death in West Australian women aged 40 – 64 years. BreastScreen WA is Western Australia's only accredited FREE screening mammography and assessment service.
The role of the GP
- Research demonstrates your encouragement will increase the likelihood of women attending a screening mammogram. Although a doctor’s referral is not essential, General Practitioners are valued by BreastScreen WA as having a fundamental role in encouraging women to have a screening mammogram and in the management of screen detected breast lesions.
- Women are asked to nominate a GP that their results can be sent to.
Who can have a screening mammogram?
- BreastScreen WA specifically targets asymptomatic women aged 50-74 years as studies show if 70% of women in this age group participate in screening, a statistically significant reduction in mortality from breast cancer can be achieved compared to women who are not screened.
- Women aged 40-49 years can attend but there is less proven benefit for screening women in this age group.
- Women aged 75 years and over are welcome to attend but are not re-invited. BreastScreen WA recommend women in this age group consult with their health care providers whether to continue screening mammography.
- Screening mammography is for asymptomatic women. Women with any breast symptoms (eg. breast lumps, nipple discharge) should be thoroughly assessed and investigated elsewhere. Referral to a screening service is inappropriate and may cause unnecessary delay in diagnosis and anxiety for women. A negative mammogram does not alter the necessity for a full clinical assessment and investigation of a breast symptom.
How often should women have a screening mammogram?
- Women will be re-invited every two years until age 75 years. If women over 75 years want to have a screening mammogram, they are welcome to phone 13 20 50 to make an appointment prior to their due date.
- Women with a personal or significant family history of breast cancer will be invited annually.
Should women have an ultrasound instead of a mammogram?
- Mammograms are more sensitive at detecting breast cancer than ultrasound in women over the age of 50.
- Microcalcifications (small calcium deposits), which are an important early sign of breast cancer, cannot be reliably detected by ultrasound.
- Breast ultrasound is an adjunctive imaging tool for assessing mammographic and clinical abnormalities.
What happens when a woman has an abnormal mammogram?
- An appointment for further assessment is discussed by a BreastScreen WA staff member over the phone.
- Women with an abnormality detected by screening will be invited for further investigation at a BreastScreen WA Breast Assessment Centre. Her GP is notified of this appointment in writing. Women may choose to be referred to her GP to be assessed privately at any time.
- At the breast assessment clinic, women may have further diagnostic mammographic views, ultrasound, fine needle aspirations and core biopsy. Localisation techniques (eg ultrasound, stereotactic) may be required for tissue sampling as the majority of these lesions are radiologically detected and are usually not palpable. Women may choose to be referred to her GP to be assessed privately at any time.
- BreastScreen WA provides assessment through four Breast Assessment Centres by a multi-disciplinary team, up to the point of a definitive diagnosis. If a breast cancer is diagnosed, women are referred back to her GP to be managed through the usual public or private health care services.
- The Radiologist, Surgeon, Pathologist, Radiographer, Breast Physician and Breast Assessment Nurse work together in a multidisciplinary team to provide a diagnosis as quickly as possible, preferably as a same day service.
- Counselling for a woman and/or her family is available.
- Where no evidence of breast cancer is detected after further investigation, the results are discussed with the woman and she receives a written report. Result letters are sent to her GP.
Will GPs be informed of results?
- Women are encouraged to involve their nominated GPs to discuss options for management and treatment of breast cancer.
- If breast cancer is diagnosed, the woman’s GP is advised in writing or contacted by phone if possible by the Breast Assessment Centre’s Breast Physician on the day.
- Copies of mammograms and reports are available for GPs on request.
- BreastScreen WA may contact GPs about the results of investigations of women who elect to have their assessment in the private sector. This data is used to assist with quality assurance of the program’s cancer detection rates.
What are dense breasts?
- On a mammogram, fatty tissue appears black and normal breast tissue and fibrous supportive tissue appears white or ‘dense’. Thus breast density has the potential to obscure significant breast lesions such as cancers that also appear as white shapes in the image.
- Women with dense breasts have a moderately increased risk of breast cancer and mammography is less sensitive. Interval cancers that arise following a normal mammogram result and before the next mammogram is due are more prevalent in this group of women. It is particularly important for women with dense breasts to be breast aware, and seek medical attention for any new breast symptom.
- Until such time that more coherent research evidence is available on how women with very dense breasts should be managed, BreastScreen WA is recommending to women with dense breasts that they see their GPs for regular breast examinations and that women with signs or symptoms of possibly significant breast disease be referred for additional breast imaging.
- For further information please see:
Breast Density FAQs for GPs
Breast Density Information for GPs Fact Sheet
Fact Sheets for GPs
Further information on specific topics is available...
Breast Assessment Centres
- Bunbury Screening and Assessment Service Tel: (08) 9792 2400
- Fiona Stanley Hospital Breast Assessment Centre Tel: (08) 6152 4125
- Royal Perth Hospital Breast Assessment Clinic Tel: (08) 9224 2723
- Sir Charles Gairdner Hospital Breast Assessment Centre Tel: (08) 6457 4590
For further information contact