Breast Cancer In Situ: Managing Your Medical Care: Diagnosis To Treatment Decision

It never hurts to get a second opinion before agreeing to a treatment. Breast cancer treatment is not one size fits all. In fact, there often is no one "right" answer. The key is the answer with which you are most comfortable.  

Second opinions have become so standard that doctors are not offended when patients ask for second opinions. (If a doctor objects to you getting a second opinion, it is a valid reason to change doctors).  

Insurance companies generally pay for second and even third opinions. Check with your insurer before getting the opinion so you will know how much the opinion will cost you out-of-pocket. If you have to pay, you can negotiate the fee and a payment schedule.

A second opinion should come from a doctor experienced with your condition who is not in any way related to the doctor who gave you the first opinion. According to a study of breast cancer patients at the University of Michigan: Ideally, the doctor should work with a cancer center that coordinates care using a team that includes surgeons, oncologists, radiologists, pathologists and nurses. Consulting such specialists changed the original surgery recommendations for more than half of the breast cancer patients. In several cases, the team found that the original doctor failed to follow treatment guidelines and proposed overly aggressive surgery. You are likely to find such a team at a large medical center, especially one affiliated with a medical school.

• Doctors at Comprehensive Cancer Centers certified by the National Cancer Institute (NCI) take a team approach.  You can locate an NCI center by clicking here . 
• Doctors at educational institutions also usually take a team approach.

If you have difficulty getting the appointment with another doctor, ask your doctor's office to help.

Ask your doctor to have the pathologist who prepared the original pathology report to send the pathology report and slides to a different pathologist chosen by the new doctor. The pathologist who provides a second pathology opinion will likely want to see both.

If the two opinions differ, do not accept the second opinion just because it is the last one you received. Get the two doctors to talk. Perhaps they will come up with a joint recommendation. Otherwise, continue to get opinions from qualified specialists and do research until you are comfortable making a decision.

Do not let a search for certainty provide a reason for stalling your making a decision.

To learn more about second opinions, including how to find a specialist, see the document in "To Learn More."

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