Your medical team for early breast cancer

When you have early breast cancer, you will probably have many people involved in your treatment and care.

The term ‘multidisciplinary’ is often used to describe the specialist doctors, nurses and other healthcare professionals involved in your treatment and care.

We explain what each specialist does and how to find them.

For other health professionals such as physiotherapists and lymphoedema specialists, go to Allied health care for early breast cancer. Learn about the importance of a multidisciplinary team and how it works.

Choosing your team

It’s normal to want to see the first available specialist but take time to decide if you are comfortable with each member of your medical team.

You will be involved with some of your specialists for a long time. It is important you can talk to them easily, trust them, and feel they are looking after you well.

Your GP refers you to some of the people who make up your treating team.

You may be able to choose a different specialist if you prefer.

Note: If you live in a rural or remote area, you may not have many choices. You may also have to travel long distances to see your specialists and spend more time away from home. The option to choose between different specialists is considered best practice, but it may not be possible for you.

Second opinions

While you may initially be referred to one specialist, you do not need to stay with that specialist. If you are unhappy or uncomfortable with the specialist you have been referred to, it’s a good idea to ask for a second opinion.

Remember, you may have to see these people for several years as you go through treatment and follow-up care.

Choosing public or private care

You can choose whether you would like to be treated in the public or private sector. Even if you have private health insurance you can choose to have treatment in a public facility.

Surgeon

Some surgeons specialise in breast cancer surgery and are called breast surgeons. Others, especially outside capital cities, are general surgeons.

Breast surgeons that are 'oncoplastic' can do some reconstructive surgeries but some are breast surgeons only.

They perform different procedures including:

• remove the breast cancer
• breast reconstruction, if they are trained in oncoplastics (breast cancer surgery and plastic surgery)
• surgery to the armpit ('axilla').

If you plan to have breast reconstruction surgery, ask your breast surgeon to refer you to a surgeon who specialises in breast reconstruction before having your breast cancer surgery.

How to find a breast surgeon

You will probably be referred to a breast cancer specialist by:

• your general practitioner (GP)
• a BreastScreen clinician, if you are diagnosed through a BreastScreen Assessment Centre.

But you can also find your own surgeon if you choose.

• Ask people you know for a personal recommendation.
• If you don’t know anyone with experience of breast cancer, find a local support group or ask the members of BCNA’s Online Network.
• Find BreastSurgANZ members near you on the BreastSurgANZ website.

What to ask your surgeon

Ask your surgeon if they are a member of BreastSurgANZ (of Breast Surgeons of Australia and New Zealand) or check the BreastSurgANZ directory. Most specialist breast cancer surgeons are members.

All members participate in the BreastSurgANZ Quality Audit, which records and reviews the outcomes and quality of their surgery.

Breast care nurse

Breast care nurses are registered nurses who have completed extensive studies in breast cancer. They can provide information, counselling and support, and can help coordinate your care.

How to find a breast care nurse

• Ask your surgeon if there is a breast care nurse available at your treating centre.
• The McGrath Foundation has breast care nurses throughout Australia. Their support is free and you do not need a referral.
• If you are in Western Australia, you can also access care through Breast Cancer Care WA.

Medical oncologist

You will see a medical oncologist if your plan includes some sort of 'systemic' treatment. They manage treatment using:

• chemotherapy
• hormone-blocking therapy
• targeted therapies
• immunotherapy. 

How to find a medical oncologist

Your breast surgeon decides whether to refer you to a medical oncologist before surgery or after surgery.

In the public system, they refer patients to the medical oncology department. In private healthcare, the surgeon will recommend someone (usually within this team) or they can refer you to your choice of medical oncologist.

When choosing a medical oncologist, some people like to involve their GP, family members or close friends. This can be helpful, but it is important to make the decision based on your own needs and feelings rather than what others think is best for you.

It’s important you have a good relationship with the person you choose.

What to consider

Some of the questions you might like to consider when choosing a medical oncologist are:

• Does the medical oncologist have a special interest and experience in managing metastatic breast cancer patients?
• Do they work as part of a multidisciplinary team?
• Are they linked to other services such as radiotherapy or psychology or palliative care?
• Are they easy to get to (close to home or public transport)?
• If you’re in a remote area, can they offer telehealth consultations, or help coordinate all your appointments into one trip to reduce your travel time?
• Could they help you access clinical trials, if you are thinking about them?
• Will they be comfortable to accept your approach to healthcare, whether you want to be involved in decision making or just told what to do?
• Will they understand and support your choices? For example, some people feel more in control with an intensive treatment plan, even if it means unpleasant side effects. Others are more concerned with their day-to-day quality of life and avoiding particular side effects such as hair loss.
• Are you confident you can voice your needs and feelings and they’ll be heard and taken into account?
• Would you feel comfortable discussing complementary therapies with this oncologist?

Radiation oncologist

Radiation oncologists specialise in treating cancer using radiotherapy. Their role is to decide whether radiotherapy will be of benefit and, if so, to decide:

• the area to be treated
• the dose 
• the length of treatment.

They work closely with medical oncologists. You do not need a referral.

Nurses - breast care and oncology 

Oncology nurses run chemotherapy and other anti-cancer treatments. Sometimes they help with radiotherapy. They can also provide advice on managing the side effects of treatment.

A breast care nurse is a specialist registered nurse who provides information, education and support. They are often the key contact person in coordinating your care.

To find a breast care nurse

• ask your medical oncologist or GP for a referral.
• Contact the McGrath Foundation. It has nurses throughout Australia who provide free support to people with metastatic breast cancer. Use the Foundation’s Find a breast care nurse tool.
• contact a breast care nurses directly – most are happy for direct contact, without a referral.
• contact the BCNA Helpline on 1800 500 258 and we can connect you with one.

Patient navigator or cancer care coordinator

A patient navigator is a person who helps guide you through complex information and difficult decisions during your treatment.

How to find a patient navigator or cancer care coordinator

This depends on the health care centre in which you’re receiving treatment.

Your specialist breast care nurse or specialist oncology nurse may do this, as they are usually part of your team. Or, another qualified team member may have this role.

Speak with your medical oncologist or nurse to find out if a patient navigator can be part of your care.

General practitioner (GP)

Your GP is an important member of your health care team during and after treatment. Find out Ways your GP can help. They can:

• clarify information provided by your specialists
• help you with decisions about treatment
• suggest options for both emotional and practical support.

GPs can provide the most effective help when they’re kept up to date. It’s a good idea to ask your specialists to send all test results and planned treatments to your GP.

Once you complete your active treatment, your GP is an important part of your follow-up care.

How to find a GP

If you don’t have a regular GP, or one you are not comfortable with:

• Ask family, friends or people who live near you for recommendations.
• Speak to health professionals, such as pharmacists or members of your treating team, to find out if they have suggestions.
• Search for GPs near you on the Healthdirect website.

Psychologist

Many people with breast cancer will seek counselling at some stage. A clinical psychologist can help you and your family talk through the things causing fear or worry.

In particular, they can help you:

• manage relationships
• cope with anxiety and fear
• work through loss and grief
• understand the effects that your illness might have on you and your family.

Psychologists who specialise in supporting people who have been diagnosed with cancer are known as psycho-oncologists.

How to find a psychologist

We share the ways to find a clinical psychologist at Psychology and counselling support.

Social worker

A social worker can help you and your family cope with the emotional and psychological impact of breast cancer.

Oncology social workers provide support for issues such as:

• coming to terms with your diagnosis
• talking to children and family
• relationships
• sadness and anxiety
• dealing with grief
• coping with fear and loss.

They can also provide you with resources or practical assistance for:

• employment
• finances including pensions, superannuation and benefits
• accommodation if you have to travel for treatment
• legal services
• childcare.

If you spend time in hospital, a social worker can help arrange your discharge and any care you may need at home.

How to find a social worker

Most hospitals, public or private, have a social worker. However, if you are having treatment in the private health system you may have less access to a social worker.

Pastoral care worker

Pastoral care workers help you to reflect on and talk about your life and its meaning. This may help you feel more hopeful and able to focus on things that bring you joy.

They respect all faiths and religious beliefs. They can help you to adjust to your situation and to explore possibilities for personal and spiritual growth.

How to find a pastoral care worker

Many hospitals, clinics and hospices have pastoral care workers. Ask your team if you can access care at your location. 

Pharmacist

A pharmacist can:

• explain your various medications and how best to take them
• tell you about the side effects that can occur
• give you advice on how to manage side effects of treatment such as chemotherapy.

Resources

Podcast: Forged in Fire: Relationships with your Medical Team and Self-advocacy

Podcast: Communicating with your health professionals

Podcast: Money and the Australian healthcare system

Read about Ways to reduce the financial impact of breast cancer.

Factsheet: Managing the Financial Impacts of Breast Cancer