A study published in the journal Cancer found that as many as 20 percent of breast cancer patients who seek a second opinion eventually change their treatment decision based on the new information. Alarmingly, more than half of the women in the study felt they were not presented with the full range of treatment options, in particular being offered breast-conserving surgery as an alternative to mastectomy when both procedures would be medically equivalent.

Dr. Monica Morrow and colleagues from Northwestern University in Chicago surveyed 231 breast cancer patients with early stage disease who had sought second opinions at their center. They found that only 46 percent of the patients had been given information on three potential treatment options: mastectomy alone; mastectomy with breast reconstruction; and breast-conserving surgery.

Thirty-one women were found to be eligible for breast-conserving surgery but had been initially offered only mastectomy as a treatment choice. Conversely, 23 women had contraindications to breast-conserving surgery but had nonetheless been offered it as a treatment option.

Experts recommend that if you feel at all uncomfortable with your doctor, if you consistently do not understand what is being recommended, or if you believe there are treatment options that are not being offered, you have the right-the obligation-to ask for a second opinion.

Second opinions are often pursued for reasons far beyond the risk of misdiagnosis. For example, doctors may sometimes perform procedures that they feel more comfortable with, rather than basing treatment decisions on the medical evidence available.

Even if there are no treatment alternatives to sort out, and no problems exist between you and your doctor, a second opinion can offer a fresh perspective. Maybe it can confirm a diagnosis or reinforce the wisdom of a course of treatment, and thus ease any doubts that you, or your family, may have. If you sense reluctance from your doctor about getting a second opinion, that may be all the more reason to get one.

SOURCES:
Cancer, 2002; 94:889-894
Northwestern University (http://www.nwu.edu)