Last summer was not easy for Janice. She had finally decided to move her parents back home, and her older daughter was leaving for college. She was so distracted, she almost forgot to get a mammogram.
Soon after she had the mammogram (which led to an unexpected biopsy), she was at her son’s soccer practice when she received a call from the hospital. She tried to ignore the calls at first — but then she picked up.
“Janice, the doctor wants to see you to go over the biopsy report.” The voice on the other side was serious and did not explain or answer any other questions.
“Why do I have to come in? Can she just give it over the phone…?” Janice was annoyed that she would have to take time off from work.
“She wants you to come here to get the results.” The woman on the other side of the line was firm.
“Is it cancer?” Janice hesitated and did not want to use the term, as if using it may make it real.
“The doctor wants to see you…” The woman just repeated what she said before.
That was the beginning of a roller coaster ride for Janice. She did not understand many things the doctor said. Terms like ductal carcinoma in situ (or DCIS), lumpectomy, mastectomy, radiation — she was totally confused. Her husband, who has no medical background, did not understand either.
“Is it cancer?” Janice asked again.
“Yes, DCIS is cancer, but it’s not invasive.” Her doctor was getting frustrated, too. She looked at her watch.
Janice knew three teachers working in her school were diagnosed with breast cancer, and one died last year after a long struggle. She thought about her daughter and son, and wondered who would take care of them if she died. She could not think straight.
Janice broached, “What is the next step?”
“You will see a surgeon and he will talk about removing the tumor or removing the whole breast,” the doctor said.
Janice’s best friend Melissa insisted she get a second opinion. At first, Janice didn’t want to. She just wanted to have the surgery and move on; she had too many things going on in her life, and she couldn’t put them on hold.
She was hesitant to ask for a second opinion, thinking the surgeon she saw at the local hospital might get angry or annoyed. The local surgeon was very decisive; he talked about removing the breast or removing the tumor and doing radiation therapy. Janice wondered what else could be done if she went to a bigger hospital.
She took her friend’s advice and got a second opinion at a bigger cancer center. She was surprised by what she learned.
“I don’t think you have cancer.” The oncologist and surgeon reviewed and confirmed the pathology report from her hospital.
“We don’t think you need to remove the breast, nor do we think you need radiation.” Janice stopped hearing after they said she didn’t have cancer.
But her husband was confused. How can one hospital say Janice has cancer, and another hospital say she does not — after looking at the same biopsy? Whom we should believe? What if the larger cancer center is wrong?
DCIS, which is a non-invasive form of cancer, is one of the most controversial breast cancer diagnoses. There is tremendous debate about over diagnosis and over treatment with DCIS. A recent study showed that 25 percent of the time, pathologists disagree with one another in making a diagnosis of cancer.
Having an experienced pathologist look at your biopsy is the most important step in the treatment of breast cancer. It is especially critical when someone gets a diagnosis of DCIS, many times over-diagnosed in inexperienced hands. An overdiagnosis could lead to unnecessary surgery and radiation.
Janice was so happy she sought a second opinion because it saved her breast, not to mention unnecessary procedures, expense and stress. Unfortunately, many patients have concerns similar to Janice, speculating that getting a second opinion would anger the doctor and hospital she has come to trust. In reality, though, getting a second opinion is an important way a patient can be his/her own health advocate. Given the challenging and complex nature of cancer, a physician will be supportive of one’s decision to get another expert’s perspective.
More from U.S. News
14 Things You Didn’t Know About Nurses
Which Practitioner Do I See, and When?
What Not to Say to a Breast Cancer Patient
Getting a Second Opinion May Save More Than Your Breast originally appeared on usnews.com
