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Second Opinion Provides Options if Breast Tumor

A diagnosis of breast cancer leads to immediate stress and often the desire to undergo surgery or radiation as quickly as possible. However, a new study finds that among women diagnosed with breast cancer, seeking a second opinion from a multidisciplinary board of specialists’ results in a change from the original treatment plan in more than fifty percent of cases.

Second Opinion Provides Options if Breast TumorThe astounding change in treatment approach is influenced by the collaborative opinion of specialists from different disciplines devoted to treating breast cancer, including surgery, radiation oncology, medical oncology, radiology and pathology. The sub-specialist opinion applies the most recent research findings and is often delivered from a single setting providing convenient access to the patient.

Researchers from the University of Michigan Comprehensive Cancer Center, looked at the records of 149 consecutive patients referred to the U-M Cancer Center’s multidisciplinary breast tumor board for a second opinion. The patients had already been diagnosed with breast cancer after having undergone initial evaluation, breast imaging and biopsy, and they already had a treatment recommendation from another hospital or care provider.

Overall, 52 percent of the patients evaluated had one or more changes in their recommendations for surgery. The changes were a result of breast imaging specialists reading a mammogram differently or breast pathologists interpreting biopsy results differently. In some cases, the initial recommendation was changed after the case was reviewed by medical oncologists and radiation oncologists prior to surgery.

Results of the study appear in the Nov. 15 issue of the journal Cancer.

“A multidisciplinary tumor board that involves the collaborative effort of multiple medical specialties allows expert opinion and recommendations based on the most recent research findings. Meanwhile, the patients come to only one setting, with no need to visit multiple specialists individually,” says study author Michael Sabel, M.D., assistant professor of surgery at the U-M Medical School and part of the U-M Cancer Centers multidisciplinary breast tumor board.

The study authors found the initial treatment recommendations often did not consider new surgery techniques, such as delivering chemotherapy before surgery to make breast conservation possible or sentinel lymph node biopsy, a new technique to determine whether cancer has spread beyond the breast. Thirty-two percent of patients had their surgery recommendations changed based on a multidisciplinary approach to surgical management

The researchers found radiologists re-interpreted imaging results in 45 percent of patients, in some cases identifying previously undiagnosed second cancers. More than a quarter of patients were recommended to undergo another biopsy. Previous studies have documented variation in how radiologists interpret mammograms. Those who specialize in breast imaging tend to detect more abnormalities.

In addition, a dedicated breast pathologist can make a difference in how the cancer is staged, which in turn can affect treatment recommendations. In this study, the tumor board pathologists interpreted test results differently in 29 percent of patients. For some patients, this meant a change in diagnosis, for other patients it affected the aggressiveness of their tumor.

Source: University of Michigan Health System

Second Opinion Provides Options if Breast Tumor

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Second Opinion Provides Options if Breast Tumor. Psych Central. Retrieved on May 27, 2018, from https://psychcentral.com/news/2006/11/30/second-opinion-provides-options-if-breast-tumor/442.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.