You have been referred with a Breast lump
What to expect from your assessment and care
By Graeme Millar, Lead Breast Surgeon – Otago Surgical Associates
Being referred with a breast lump can be unsettling. For many people, this referral comes with understandable anxiety and uncertainty. My role and the role of the team at Otago Surgical Associates (OSA), is to guide you carefully and compassionately through the assessment process, ensure nothing important is missed, and support you at every stage, whatever the outcome.
As a Breast Cancer surgeon, my day-to-day work focuses on assessing breast symptoms to determine whether cancer or other serious conditions are present. I am part of a large multidisciplinary breast team, and together we provide locally delivered, evidence-based care for patients across Dunedin, Otago, and surrounding regions.
Why you have been referred
Most breast lumps turn out to be benign (non-cancerous). However, the only safe approach is to assess every breast lump properly. Referral allows us to:
Determine the cause of the lump
Exclude or confirm breast cancer
Provide reassurance when appropriate
Arrange timely treatment if needed
Early and thorough assessment leads to the best outcomes.
The goal: a complete diagnosis before any surgery
Wherever possible, our aim is to achieve a complete diagnosis before surgery. This means combining:
Clinical history and examination
Imaging findings
Needle biopsy, if required
This approach helps avoid unnecessary surgery and ensures that, if an operation is needed, it is the right operation for you.
If breast cancer is diagnosed
If cancer is identified, you will not face this alone.
I work as part of a large multidisciplinary breast cancer team, which includes:
Radiologists
Pathologists
Medical and radiation oncologists
Breast care nurses
Allied health professionals
Together, we develop an individualised treatment plan tailored to you—not just to your diagnosis, but to your overall health, preferences, and circumstances.
For some patients, the early months after diagnosis can feel confronting. During this time, our team provides very hands-on care and support, helping guide you through surgery and any additional treatments that may be required.
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Your first appointment will take place either:
At our OSA rooms at Suite 6, Marinoto Clinic, Dunedin, or
At my private clinic at Balclutha Hospital, which I hold twice each month
At this visit, we take time to ensure a careful and unhurried assessment.
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A full breast history, including when the lump was noticed and whether it has changed
Review of any other symptoms such as pain, nipple discharge, or skin changes
A general health history, including medications and past medical issues
Discussion of family history of breast or ovarian cancer
A chaperoned breast examination, carried out respectfully and professionally
Following the examination, we sit down together to discuss the findings and next steps
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In many cases, further investigations are required to reach a clear diagnosis. This is a normal and expected part of breast assessment.
Most commonly, this involves breast imaging, such as:
Mammography
Breast ultrasound
Occasionally MRI, if clinically indicated
These tests are usually arranged locally through Pacific Radiology, and sometimes if you are self funding or your insurance policy does not cover imaging we can get them done publically through Dunedin breast care services, allowing results to be obtained efficiently without the need to travel out of Otago.
Increasingly, assessment may also include point-of-care ultrasound performed during your clinic visit. This technology is becoming part of in-clinic breast assessment and can provide immediate additional information in selected cases.
If a biopsy is required
If an area needs further clarification, a needle biopsy may be recommended. This is a minimally invasive procedure performed under local anaesthetic. Most people tolerate it very well and return home the same day.
Biopsy results are done as quickly as possible but can take a few days to one to two weeks to finalize, and I will discuss these results with you carefully, explaining what the results mean and what happens next.
At Otago Surgical Associates, we believe breast care should be:
Local – provided here in Dunedin and Otago
Personalised – tailored to each individual
Clear and honest – with time taken to explain findings and options
Supportive – recognising the emotional impact of breast symptoms and treatment where required
Our approach at OSA
Whether your assessment leads to reassurance or treatment, our focus is on guiding you safely and confidently through each step.
Being referred with a breast lump does not mean you have cancer. Most patients are relieved to learn their symptoms are benign. If cancer is found, early diagnosis and coordinated care offer excellent outcomes.
If you have been referred to see me, my commitment is to ensure you receive expert assessment, clear communication, and compassionate care—here in Otago—through every stage of your breast health journey.