The important role of General Practitioners in breast cancer care

When people think about breast cancer treatment, oncologists, surgeons, and specialist teams may come to mind. Yet recent New Zealand research, highlighted a fundamental reality: for many cancer patients, one of the most important people in their healthcare journey is a General Practitioner (GP).

The researchers found that GPs are the ones that often determine what pathway a person takes, including referral to specialist care and accessing diagnostic tests. The actions of GPs can significantly influence a patient’s journey to recovery, balancing consideration of the person symptoms, medical history, and knowledge of the healthcare system.

This research echoes findings from recent patient journey research conducted by Breast Cancer Foundation NZ, investigating patients’ perception and experiences through breast cancer diagnosis, treatment and follow up.

GPs are typically the first healthcare professionals a person is encouraged to consult when breast cancer symptoms arise. Our research showed that GPs play a critical role throughout – from education, detection, referrals, specialist appointments, and ongoing support including monitoring and detecting recurrence (the cancer coming back).

In the first instance they can be seen as “gatekeepers”, tasked with finding the right balance when deciding if a person should be referred e.g. when it is appropriate or not appropriate to refer a person, or circumstances when it is not necessary. GPs must balance all these factors against the risk of missing a breast cancer diagnosis.

GPs also can make a significant difference in the access to, and speed of treatment patients receive by acting as “brokers”, where they actively help patients navigate the healthcare system. GPs who know their patients well are better positioned to recognise changes, push for referral to assessment, and coordinate care across multiple services. They play a key role in bridging gaps when people diagnosed with breast cancer need help, pushing for the best care for their patients.

Both research pieces also identified that the western conventional medical approach vs a holistic cultural and spiritual approach was an area where current methods did not fully meet the needs of some patients. In our research, Māori patients signalled that having whānau involvement was important in their breast cancer journey, as was having personalised and cultural-centred care, including normalising cultural practices and complementary therapies.

After a patient is discharged, GPs continue to play an important role of supporting, monitoring and reducing the chance of the breast cancer coming back. Over 17,000 patients per year are prescribed hormone therapy to prevent breast cancer from returning, requiring them to take a pill every day for five to ten years.

The patient’s GP, or specialist team, have the important role of supporting them through various side-effects, as stopping the therapy can increase the chances of the cancer coming back. Managing side effects and staying on treatment can be challenging, which is one reason Breast Cancer Foundation NZ developed myHT Guide to provide additional support and information.

Both research studies raised important questions about how the healthcare system supports GPs, noting that primary care practitioners often work with limited resources while carrying significant responsibility for identifying serious illnesses such as breast cancer. Ensuring GPs have the tools and resources needed to investigate concerns early, and support their patients throughout their journey, will greatly influence the results for patients.

Deaths from breast cancer can be avoided through receiving the right treatment quickly and reducing the risk of recurrence through monitoring and support – and at every stage GP’s play a major role. But the starting point is getting a diagnosis as early as possible.

So, if you notice a lump, changes in your breast or nipple or any other unusual symptom, do not wait, even if you’re regularly going for mammograms. Make an appointment with a GP and ask them to investigate it. Most of the time, breast changes won’t be breast cancer. But the quicker you act, the sooner a GP can refer you for diagnosis and help you access the treatment you need, which will make a significant difference.

References

Dew K, Chamberlain K, Egan R, Dennett E, Cunningham C. Cancer journeys and health practitioners as gatekeepers, brokers, and boundary enforcers. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. Published online February 2026.