Do you need a referral for risk-reducing mastectomy?

Some services accept direct appointments, while others ask a family doctor, breast specialist, genetic specialist or another clinician to refer you. Contact the intended clinic before arranging records or travel so you know its current requirements.

A referral introduces you to the surgical service and usually summarises why an assessment is being requested. It does not commit you to surgery or confirm that the operation is suitable. The specialist team considers your personal and family history, any genetic results, previous breast care, general health and your preferences. Counselling about alternatives, reconstruction choices, expected body changes and possible surgical harms is part of informed decision-making.

Call the breast or surgical oncology clinic and ask whether it accepts self-referrals. If a clinician’s referral is required, request one from the doctor coordinating your care. Gather relevant genetic reports, breast imaging, biopsy or operation reports, a medication list and details of cancers in close relatives. Ask whether the clinic needs images themselves as well as written reports. If you are considering reconstruction, check whether breast and reconstructive specialists can coordinate consultations.

Risk-reduction planning is generally arranged through a scheduled consultation. A new breast lump, bloody nipple discharge, skin dimpling, new nipple inversion, redness with fever, or a rapidly changing breast should be assessed promptly rather than waiting for a prevention appointment. Tell the booking team about the symptom so it can direct you to the appropriate clinical pathway. Seek urgent care for severe illness, breathing difficulty or uncontrolled bleeding.

Ask what information supports the recommendation, whether further genetic counselling or breast imaging is needed, and what non-surgical surveillance options remain available. Discuss whether one or both breasts would be considered, how reconstruction timing affects planning, what recovery may involve, and how surgery could affect sensation, body image and future procedures. Also clarify which clinician will coordinate follow-up.