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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2018

Open Access 01-10-2018 | Breast Oncology

The Value of a Second Opinion for Breast Cancer Patients Referred to a National Cancer Institute (NCI)-Designated Cancer Center with a Multidisciplinary Breast Tumor Board

Authors: Denise Garcia, MD, MEd, Laura S. Spruill, MD, PhD, Abid Irshad, MD, Jennifer Wood, RN, BSN, CBCN, Denise Kepecs, RN, BSN, CBCN, Nancy Klauber-DeMore, MD, FACS

Published in: Annals of Surgical Oncology | Issue 10/2018

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Abstract

Background

This study aimed to investigate the changes in diagnosis after a second opinion for breast cancer patients from a multi-disciplinary tumor board (MTB) review at an National Cancer Institute (NCI)-designated cancer center.

Methods

A retrospective study analyzed patients with a breast cancer diagnosed at an outside institution who presented for a second opinion from August 2015 to March 2016 at the Medical University of South Carolina (MUSC). Radiology, pathology, and genetic testing reports from outside institutions were compared with reports generated after an MTB review and subsequent workup at MUSC. The second-opinion cases were categorized based on whether diagnostic variations were present or not.

Results

The review included 70 patients seeking second opinions, and 33 (47.1%) of these patients had additional radiologic images. A total of 30 additional biopsies were performed for 25 patients, with new cancers identified in 16 patients. Overall, 16 (22.8%) of the 70 of patients had additional cancers diagnosed. For 14 (20%) of the 70 patients, a second opinion led to a change in pathology interpretation. Genetic testing was performed for 11 patients (15.7%) who met the National Comprehensive Cancer Network (NCCN) guidelines for genetic testing, but none showed a mutation other than a variant of unknown significance. After a complete workup, 30 (42.8%) of the 70 patients had a change in diagnosis as a result of the MTB review.

Conclusion

A review by an MTB at an NCI-designated cancer center changed the diagnosis for 43% of the patients who presented for a second opinion for breast cancer. The study findings support the conclusion that referral for a second opinion is beneficial and has a diagnostic impact for many patients.
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Metadata
Title
The Value of a Second Opinion for Breast Cancer Patients Referred to a National Cancer Institute (NCI)-Designated Cancer Center with a Multidisciplinary Breast Tumor Board
Authors
Denise Garcia, MD, MEd
Laura S. Spruill, MD, PhD
Abid Irshad, MD
Jennifer Wood, RN, BSN, CBCN
Denise Kepecs, RN, BSN, CBCN
Nancy Klauber-DeMore, MD, FACS
Publication date
01-10-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6599-y

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