Breast Cancer Second Opinion: How and When to get one

We teach you when to consider a second opinion and outline the advantages and disadvantages of a second look at your breast cancer treatment options.Visit our website:

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When should you consider a second opinion?

Be reassured that most newly diagnosed patients do not need a second opinion. We outline here a few situations in which you may benefit from seeking a second opinion about your breast cancer.

When you have a very unusual type or complicated breast cancer.
When your surgeon or oncologist recommends a second opinion.
When a clinical trial is available for your unique situation.

What are the advantages of a second opinion?

Reassurance and confirmation that your physician and breast cancer team is approaching your situation correctly.
A possible offer of a different approach to treating your cancer. You can then weigh the advantages and disadvantages of both approaches and make a more informed decision.

What are the disadvantages of a second opinion?

This process can sometimes significantly delay beginning your cancer care. Depending upon the facility and availability of the second opinion appointment, the delay can be a few days to many weeks.

If you do choose to return to your original physician to seek your cancer care, your surgery, chemotherapy, or radiation therapy will likely be delayed by your second opinion. However, if you work with your initial specialist to help you coordinate a second opinion as outlined below, he or she may likely work to continue scheduling therapies while you are seeking other ideas.

How do I best seek a second opinion?

Ask your surgeon or oncologist who they would recommend you see. They know who is the best in your area. This also indirectly asks them the question, “Are there any other services that are offered elsewhere that are not available here?” They can be very helpful in facilitating this referral and sharing your medical records for your second opinion. If your surgeon/oncologist appears offended when you ask this question, this is an indication that you may benefit from a second look at your breast cancer treatment options.

Conduct your research. Look online for NAPBC accredited Breast Centers in your area. Contact the “Patient Navigator” at the breast center you are considering a second opinion. He or she will be very helpful in having you “worked in” to a physician’s busy schedule to have second look at your unique breast cancer situation.

What is a breast biopsy, “pathology second opinion?”

An incorrect reading of your breast biopsy can dramatically change your physician’s approach to your problem. Sometimes it is challenging to accurately determine whether breast cells are benign, atypical, precancerous, or an invasive breast cancer. Your pathology slides can be sent to an outside reference lab if there are questions about the certainty of a diagnosis with your local pathologist.

In 2015, actress Rita Wilson publicly shared that a pathology second opinion of her breast biopsy showed invasive cancer, after initially being read as a more benign condition. A good commentary of her second opinion is located (here).

Breast biopsy pathology second opinions are not routinely ordered. Here are a few situations that can generate sending pathology slides to a reference lab. Ask your breast surgeon if a second reading would be helpful in your unique situation.

If the reading was performed at a very small hospital pathology laboratory.
If the reading suggests one of the following diagnoses: atypical lobular hyperplasia (ALH), atypical ductal hyperplasia (ADH), lobular carcinoma in-situ (LCIS), or lobular intraepithelial neoplasia (LIN).

What is a breast “imaging second opinion?”

Formal requests for second readings of mammograms, breast ultrasounds, and breast MRIs are rare. But if you visit another institution for a second opinion to treat a newly diagnosed breast cancer, it’s commonplace to have a new, formal reading by that institution’s breast radiologists.

The most reassuring second opinion is when your breast surgeon offers to review your imaging with your radiologists. This action shows engagement in your care and can add further insight into your breast cancer situation.

Patient-Friendly References:

This detailed outline (here) “Getting a Second Opinion” is about all aspects of seeking a second opinion for breast cancer. This non-profit organization provides excellent patient resources about breast cancer.

[charlotteruse]

I'm going for a second opinion and I feel like I'm being sneaky. My oncologist told me that the treatment for my stage and type is and has been the same for 40 years and and I believe him and trust him on that part. I asked him a few questions about what I had read on my lab report and he never responded either way and that was the extent of our conversation. That is why I'm going to get not even what I would call a second opinion. I'm 60 years old is chemo going to kill the cancer but in effect kill me too?

[simrandubey]

Please do make a video on breast cancer with leptomeningeal metastasis would be really great help 🙏

[mymakeuptacklebox]

I had a breast biopsy done yesterday, My Experience was horrific and terrifying, The Dr. didn’t seem to be prepared, Every time he stuck the needle in he seemed to be struggling to get to the spot, it was like he was jamming the needle through, I did feel some pain, He asked the technician for a smaller needle she said they didn’t have any smaller needles, he took tissue further from the spot on one of his collections, and also when he placed the marker and brought back the needle he was looking at it and told the technician he needed a new marker, she left the room, I asked him what happened he said it’s just articraft and showed me the needle with broken little wires, and said it didn’t deploy, the technician came back and he put the new marker in, I was sent to another room for a mammogram. I called the Dr. office and asked to speak with someone concerning my biopsy and I needed to know if pieces of the marker were broken inside me, the lady that answered said the Dr. would call me back. He said not to worry the marker didn’t break and that’s the way the marker looked he also mentioned that he went further in grabbing tissue and if I had remembered that, he said it was perfectly fine that sometimes they don’t get the spot and not to worry. Well I’m worried, I don’t think this Dr. was prepared and I don’t think what I experienced is normal, now I have to wait on a pathology report that I don’t know will be accurate because of the biopsy and what if their is something broken inside of me that can’t be seen?

[nonyabiness]

I was just diagnosed 2 months ago with triple negative breast cancer. I beat invasive carcinoma 12 years ago. This time I had a bilateral mastectomy. No cancer in my lymph nodes, no evidence of cancer found in remaining breast tissue. The tumor was only 7x4 millimeters. Very small, very early. Aggressive type however. So 7 weeks post op I started chemo. He hit me with the strongest dose and I didn’t think I’d make it through the week. At my appointment I expressed my frustration and was told the lighter dose is just as effective. Then why hit me with that strong dose in the first place? I’m 51 years old and always healthy and active. I never felt so defeated in my life! Was that necessary? Obviously not but good lord! I told them with the straightest face, you’re trying to kill me!

[cybersis]

“Most of the time you’re in good hands”. Most?? 6:50 How would I even know?? I do not know any cancer doctors. I know people that have survived cancer and can get their docs name. I do not know this oncologist I’m going to see, he doesn’t know me of course but will he just think I’m a hysterical woman and not even listen to what is important to me.

[kristyb]

I’m really scared. I feel like my breast surgeon hasn’t been listening to me and what I need in terms of appointments. It’s 65 miles each way which with traffic can be an hour and a half to two hours of driving each way, on top of the additional expenses of lost time from work ( I generally have to lose a full day because 2 hours there, 2-3 hours in the clinic and 2 hours back eats up my whole day) and also the expenses of traveling. I asked to schedule our appointments via telehealth as most of these appointments it’s not needed for me to be there physically. We haven’t even gotten to setting a surgery date yet but I was immediately sent to plastic surgery to consult. I still haven’t seen my medical oncologist as my diagnosis is new but the surgeon is saying bilateral mastectomy is my only option and if I don’t do it I’ll be dead like my mother that died from breast cancer. I feel like all she does is stress me out even more than I was getting the diagnosis. I was sobbing my heart out in there and clearly overwhelmed but forced into meeting with plastic surgery without even time to even process what she was saying and that lead me to very unsuccessful visit with plastic surgery. I feel like I need to talk to medical oncology before being told that mastectomy is my only option. I saw a medical oncologist in my town and he said it looks to him like I’m a good candidate for neo adjuvant therapy but the surgeon disagreed. I’m so frustrated and so scared that I’m going wind up like my mother who was only 42 when she died of breast cancer. I don’t want the bilateral mastectomy but I also don’t want my son to go through the pain I went through losing my mom at such a young age. Any advice?

[tommac]

This is a silly video. Aways, always get a 2nd opinion. Why would he even bring this up. Oh because he doesn't have to deal with it nor has he ever experienced this. Why don't men just stick to mens health and women with womens health. He doesn't know what a woman goes through. And vice versa