The Power of a
C
Second Opinion
Caroline was a healthy 46 year old
diagnosed with breast carcinoma in
situ following a radiology biopsy done
after an abnormal mammogram. As
with many women, she was eager
to proceed with treatment and was
quickly referred to a surgeon through
her primary care with no forethought
or research on treatment options. She
was scheduled for a lumpectomy
and node biopsy only to find out a
month later that the cancer was more
advanced, and she would require further surgery and treatment. Review of
the pathology from the first surgery
confirmed an invasive high-grade cancer that would have been better treated
with mastectomy, chemotherapy and
postoperative radiation. Performing the
incorrect surgery only delayed treatment and added more pain and confusion to an already stressful situation.
Caroline i s like many patients in that
she did not consider a second opinion
96
WRITTEN BY Nancy Palermo Lietz, MD
PEACHYTHEMAGAZINE.COM
prior to her surgery. In fact, only one
in every five patients seeks a second
opinion. This number is fairly constant
even when the diagnosis involves
cancer or another complicated or serious diagnosis. A 2015 study in the
American Journal of Medicine reviewed
the outcomes of a National Patient Initiated Second Opinion program from
Best Doctors, Inc. It revealed patients
only sought second opinions in about
20 percent of cases. When they did, it
was most commonly related to treatment options (41 percent) and diagnostic concerns (35 percent). The study
found that second opinions resulted in
changes in the diagnosis or treatment
41 percent of the time.
Patients generally don’t seek a second
opinion because they do not want to
upset their current physician, or they
are eager to proceed with treatment.
Many patients are also concerned that
a second opinion will be an extra cost to