A Second Opinion

As scary as a cancer diagnosis can be, pausing to get more information can yield benefits.

In a recent study on the value of a second opinion for breast cancer patients, researchers concluded that a review by a tumor board at an NCI-Designated Cancer Center changed the diagnosis for 43 percent of the patients.

In a recent study on the value of a second opinion for breast cancer patients, researchers at the MUSC Hollings Cancer Center concluded that a review by a tumor board at an NCI-Designated Cancer Center could yield major benefits.

All the stories are different. The ages of the patients. The stages of the cancer. The prognosis. The diagnosis.

What remains the same throughout each case, though, is the intensity of the discussion and the wide breadth of comments based on the specialty of the medical professionals who are weighing in. There are radiation oncologists, surgical oncologists, medical oncologists, nurse navigators, radiologists, geneticists and pathologists.

Some of the questions on the table: Does this patient have the right diagnosis? What’s the best treatment? What are other lifestyle considerations? Do they need cryopreservation? What are their wishes in how they get treated?

Published in the Annals of Surgical Oncology, the study looked at the value of a second opinion for breast cancer patients referred to a National Cancer Institute-Designated cancer center with a tumor board. Researchers concluded that a review by a multidisciplinary tumor board at an NCI-Designated Cancer Center changed the diagnosis for 43% of the patients who presented for a second opinion for breast cancer.

The review included 70 patients seeking second opinions. A total of 30 additional biopsies were performed for 25 patients, with new cancers identified in 16 patients. Overall, 16 or 22.8% of the 70 of patients had additional cancers diagnosed.

“Those findings would drastically change care,” surgical oncologist Nancy DeMore, M.D. said. “We found the pathology review changed in 20% of people. And 16% of people who met guidelines for genetic testing by the National Comprehensive Cancer Network (NCCN) guidelines for genetic testing had not been referred for testing.”

Many people may not know the level of specialty care when they seek care, and patients can be in a state of shock when they get a cancer diagnosis. “It’s important to pause and regroup and make sure you have the right plan.”