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Breast Cancer Care & Research Fund Breast Cancer Care & Research Fund : Article Doctors encourage second opinions for breast cancer diagnoses
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Doctors encourage second opinions for breast cancer diagnoses

By Jacqueline Baylon
jbaylon@sacbee.com
Published: Friday, Jul. 23, 2010


It can be intimidating for a patient to second-guess a doctor.

But a jarring report this week that early breast cancer diagnoses are prone to error should encourage patients not to shy away from asking for a second opinion, Sacramento-area medical experts say.

"We are never offended by anyone wanting a second opinion," said Dr. Lydia Howell, acting chair of anatomic pathology at UC Davis Medical Center. "We want everyone to feel that they are getting all the information that they want and need."

An examination of breast cancer cases by the New York Times turned up news that diagnosing the earliest stage of breast cancer can be difficult and prone to both error and disagreement over whether a cluster of cells is benign or malignant, the newspaper reported.

Patients diagnosed with cancer should not be afraid to ask another doctor to reconsider, said Dr. Kathryn Amirikia, a breast surgeon at Methodist Hospital.

"They just need to say they want a second opinion from another doctor and we will gladly encourage them to do so," Amirikia said.

Second opinions usually are a matter of finding another pathologist who will go over the slides of the biopsy. Typically, patients can have the medical records transferred to another doctor once they give the authorization to do so.

After a second opinion is reviewed, patients can then decide whether they want to go back to their original doctor or stay with the new help.

For the last 10 years, Amirikia said, insurance companies have advocated for and allowed their patients to get second opinions.

Both UC Davis Medical Center and Methodist Hospital seek second opinions in-house.

"After we realize it is cancer we are looking at, we talk with other pathologists for a second opinion," Howell said.

Michele Rakoff, executive director of the Breast Cancer Care and Research Fund, was diagnosed with ductal carcinoma in situ 22 years ago. DCIS is the most common type of noninvasive breast cancer and the type that the New York Times examination found to be misdiagnosed.

Rakoff said that after she was diagnosed, she had a biopsy done. Two days later she had surgery with a doctor who was not a breast surgeon.

Rakoff said she ended up with three holes in her breasts because the doctor could not find the lesion, and there were complications after the surgery.

"I did not know I could ask about a second opinion," Rakoff said.

Rakoff said women need to know if they have a diagnosis of cancer the most important thing is the pathology report and getting a second opinion.

"Even if it is a wrong read, and it is still cancer, then they could have a better discussion about their treatment options," Rakoff said.

While the diagnosis might seem urgent, Rakoff said, patients do have time to get a second opinion.

"They do not have to react immediately, they have to get educated and they have to get a second opinion so they can see what their best option is," she said.

Copyright The Sacramento Bee. All rights reserved.

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