Referral guidelines

Patients 35 years of age and older:

Order a mammogram (if a recent one less than12 months is not on file).

Use the Manitoba Provincial Breast Imaging Consultation Request form to order this test. Send it to one of the two mammography facilities (MB X-Ray Clinic or Radiology Consultants)

NOTE:  As part of the Direct Referral process, the Radiologist will automatically forward your requisition on to another facility for additional tests.  You and your patient will be notified and you will be copied on the mammogram report. 


Patients under the age of 35:

Complete a Referral for Surgical Consultation at BHC.  Your patient will be assessed prior to scheduling imaging tests.


Patients under the age of 16

Refer patients directly to the Pediatric Surgery Department for assessment. 

(Phone:  204-787-1246   Fax:  204-787-4618).


Patients with Mastitis/Breast Infections

Refer after one course of antibiotics – Complete a Referral for Surgical Consultation


Please note our mandate is to provide rapid diagnosis for breast abnormalities.

  • We are not a screening or surveillance program.
  • We do not provide screening mammography or screening ultrasounds exams for women with breast implants. 

If a patient is on anticoagulation therapy and requires an invasive procedure, the referring practitioner will be responsible for determining whether the therapy can be interrupted or if alternative therapy will be initiated and managed.



To avoid delays or returned referrals, complete the referral form in full.


Click here for referrals forms

Manitoba Provincial Breast Imaging Consultation Form

Referral for Surgical Consultation

Lymphedema Assessment

Hereditary Breast Cancer Clinic Referral


If you have any questions regarding the information required or the appropriateness of your referral to the Breast Health Centre, call the Referral Assessment Nurse at 204-235-3252.

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