We conducted interviews with 85 randomly selected general practitioners (GPs) in Central Sydney to examine patterns of referral of women with breast cancer, satisfaction with local services, awareness of evidence-based guidelines and suggestions for local support. Previous experience was the most frequently cited factor influencing choice of specialist (n=80, 94%) followed by personal knowledge of the consultant’s expertise (n=72, 85%). Only one third of respondents agreed women wanted to be more involved in choosing the specialist (n=28, 33%). Of 79 women recently diagnosed with breast cancer, the majority (96%) had been referred to a male surgeon (n=71, 96%). While only 35% of the GPs rated the care received by women with breast cancer in local facilities as ‘excellent’, significantly fewer rated communication between GPs and specialists as ‘excellent’ (35% v 19%, p<0.01). Younger GPs were less likely to rate communication as ‘excellent’ compared with GPs aged 55 years or older (p=0.01). Only 18% of GPs considered their patients as having been ‘very well informed’ about their treatment choices. Younger GPs were more likely than older GPs to recall all available breast cancer guidelines (p=0.02). Significantly more GPs (68%) requested seminars with experts than any other types of educational support (p<0.001). To improve outcomes for women with breast cancer, mechanisms to support communication between GPs and specialists are recommended. Seminars for GPs with experts who emphasize evidence-based guidelines should be funded and evaluated, especially for impact in meeting the needs of older GPs.