Changes in breast cancer therapy because of pathology second opinions. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Examination of pathology slides is a routine part of a breast cancer second opinion. The purpose of this study was to determine how often the pathologic second opinion (1) altered the diagnosis and (2) resulted in a change in the surgical procedure. METHODS: Patients presenting between 1997 and 2001 for a second opinion after a biopsy diagnosis of breast cancer (invasive or noninvasive) were included in this study. RESULTS: There were 340 patients presenting for second opinions regarding 346 breast cancers. Sixty-eight pathologic second opinions (20%) did not result in any change in pathology or prognostic factors, whereas in the remaining 80%, some change occurred. Major changes that altered surgical therapy occurred in 7.8% of cases, and pathology review provided additional prognostic information in 40%. Changes were more common in in situ carcinoma than invasive carcinoma (P =.004), but biopsy type (core vs. excisional biopsy) was not a significant predictor of change in pathologic information. CONCLUSIONS: This study confirms the benefit of a pathology second opinion to improve preoperative estimates of prognosis and to determine the appropriate surgical procedure. Missing information on grade and histological subtype was responsible for a large number of cases, suggesting a need for widespread application of standardization and quality improvement in pathology reporting.

publication date

  • December 1, 2002

Research

keywords

  • Breast Neoplasms
  • Carcinoma
  • Carcinoma in Situ
  • Carcinoma, Intraductal, Noninfiltrating
  • Referral and Consultation

Identity

Scopus Document Identifier

  • 0036897052

PubMed ID

  • 12464590

Additional Document Info

volume

  • 9

issue

  • 10