There are many reasons why you may want to seek a second opinion for your breast cancer diagnosis or treatment. From your initial diagnosis to your last treatment, you’ll be faced with many decisions, and it’s important to have confidence in your care providers and the treatment protocol they prescribe. The Susan G. Komen organization reports that for a disease as complex as breast cancer, “it’s a good idea for everyone diagnosed with breast cancer to consider getting a second opinion.”
Breastcancer.org defines a second opinion as “asking another breast cancer specialist, or a team of specialists, to review all of your medical reports and test results, give an opinion about your diagnosis, and suggest treatment options. A second opinion may confirm your original doctor’s diagnosis and treatment plan, provide more details about the type and stage of breast cancer, raise additional treatment options you hadn’t considered or recommend a different course of action.”
[See: A Tour of Mammographic Screenings During Your Life.]
Seeking a second opinion can also offer you more confidence in your original doctor, and in some ways, that can be the biggest reason to get a second opinion. In 2014, patient advocate Trisha Torrey told U.S. News that “the second opinion isn’t always the one that’s right. What you’re looking for is a confirming opinion. You are looking for two opinions to say the same thing.”
Dr. William Farrar, professor of surgery at The Ohio State University Wexner Medical Center and director of the Stefanie Spielman Comprehensive Breast Center in Columbus, Ohio, says he advises his patients to get second opinions. When meeting with patients about their options for surgical treatment, Farrar says many patients ask him what he would tell his wife if she were the one facing the decision. His reply is, “I would do exactly what I told you, which means I’m not going to tell you to have a lumpectomy or mastectomy because the medical outcome is exactly the same.”
In the unusual instances where the medical outcome would be different, Farrar says he would advise the patient differently, “but in most cases the patient has the option to do a lumpectomy or a mastectomy or the fad of the day where everyone wants bilateral mastectomy. And I encourage my patients that if they don’t quite understand what I say or can’t make up their mind, to get a second opinion.”
These days, most doctors encourage patients to seek more information, and if your doctor has a negative reaction to your request for such, you may want to think carefully about whether that’s the right doctor for you. “I think any physician who downplays second opinions or tells the patient they don’t need a second opinion, I would be concerned about, because I think the more information the patient can receive, the better off they’ll be,” Farrar says.
In addition, patients with certain types of breast cancer may have even greater reason to seek a second opinion. Farrar says those with “very early in-situ cancers, such as ductal carcinoma in-situ or lobular carcinoma in situ, if you’re at a small hospital with a pathologist who doesn’t have great experience in those areas, those can be misread anywhere from 10 to 15 percent of the time, which may change your treatment.” In those situations, he recommends seeking a second opinion “to make sure that what you’re operating on is really what you think you’re operating on.”
[See: What Not to Say to a Breast Cancer Patient.]
Mary Gemignani, attending surgeon and program director for surgical fellowship at Memorial Sloan Kettering Cancer Center, also encourages her patients to seek a second opinion because it gives them another opportunity to become better informed. “Sometimes when you meet the first doctor, everything is overwhelming, but by seeking a second opinion, you get to rethink it and hear it in a different way. Even if they’re saying the same thing,” hearing it twice after having had a short period to think it over can help you understand it better.
She says that patients may also derive value from having a new assessment of their diagnosis. “The doctors may differ in their expertise, and may offer different options, so I would encourage most patients to have a second opinion.”
Although acquiring more information is generally a good idea, Gemignani doesn’t recommend going for a third opinion in the same specialty in most cases. “I think it just makes it so complicated. I’ve seen patients who’ve seen multiple doctors, and they aren’t considerably better off than those who don’t,” and she says seeing three surgeons to discuss your surgical treatment options would be “a little overkill. But I would encourage a second opinion, and I think there’s a lot of value to it.”
She says this is true not just of the surgical decisions you’ll have to make, but for everything from the initial diagnosis to deciding whether or not to have breast reconstruction. But she also offers a caveat to that — if you seek a second opinion on every single step, that can slow down your treatment, which could become a problem depending on the type of cancer you have and the sequencing of certain aspects of treatment.
Gemignani also notes that dealing with breast cancer is a multidisciplinary effort, and figuring out how all the pieces of treatment will work in concert is important to achieving a satisfactory outcome. “It’s important to not look at the one aspect that you’re having the second opinion about in a vacuum.” For example, she says that although “you may love your surgeon,” you need to consider how surgery fits in with other aspects of treatment and be aware of how the whole care team works together. “Look at the big picture,” she urges.
Gemignani says that in some instances where she’s been the surgeon offering the second opinion, the patient will ask questions that she thinks should have already been addressed. In those instances, she becomes “the educator going through all the components when I’m supposed to just be the second person reinforcing.” She says that if patients find the second surgeon is presenting new information, they may want to carefully review what their first surgeon said and compare their approaches. Sometimes it can be hard to tell who is right when there’s a clear contradiction in what’s presented. Here, doing your own research may be helpful in determining which path forward is best.
[See: 7 Innovations in Cancer Therapy.]
And doctors aren’t the only people whose opinions may offer value during your decision-making process. Gemignani encourages you to bring a loved one or close friend with you to your appointments to help you take notes and ask clarifying questions. “Two sets of ears can help,” and having someone there for moral support and to take notes while you’re listening can be very valuable.
Similarly, speaking to a patient who’s been through the process before or has worked with your doctors may also provide additional insight and ideas for questions you should ask when making decisions about your care. Your doctor or hospital may be able to connect you with other patients or a support group that could help.
More from U.S. News
7 Innovations in Cancer Therapy
Breast Pain? Stop Worrying About Cancer
A Tour of Mammographic Screenings During Your Life
Should I Seek a Second or Third Opinion for My Breast Cancer? originally appeared on usnews.com
