Why a pathology second opinion?

Treatment decisions for breast cancer and their likely success are critically dependent on the analysis of the pathologist which is summarized in the pathology diagnosis. As a colleague once put it: “The diagnosis is like an architect’s drawing; if it is faulty, the house will collapse”.  Many women receive second opinions in the course of making a therapeutic decision for their breast cancer but most such opinions rely on review of the written reports and not direct re-examination of the pathology slides, the basis for the diagnosis.  At present, with many new breast cancers of minute size or entirely non-invasive, the issue of a direct review of the diagnostic materials becomes even more critical.  Inadvertent errors in interpretation, either for the actual diagnosis of carcinoma, or in evaluating size, stage and margins, are commonplace.  A recent patient guidelines brochure developed by the NCI and the ACS strongly recommends a pathology review of the slides, particularly for duct carcinoma in situ and other non-invasive lesions for which the error rate on review may be as high as 35%.  A second opinion may make the difference between a benign hyperplasia vs. an in situ carcinoma, the need for re-excision, radiation therapy and/or chemotherapy.  Second opinions can also help by confirming a diagnosis and providing reassurance that the patient is making a reasonable choice.

Physicians wishing a second opinion on their patient's pathology may call our office for details about this service.