Second opinions on pathology reports could change your diagnosis or treatment recommendations
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By examining samples of tissue, blood, and other body fluids, pathologists play a key role in diagnosing not only cancer but a range of other conditions including autoimmune diseases, genetic conditions, diseases that affect the internal organs, and some infectious diseases. They use a number of different tools to reach their diagnoses, including microscopic examination, laboratory testing, and imaging technologies. Pathologists are highly trained medical providers and must earn a medical degree and complete residency training. Many also complete additional fellowship training.
A second opinion from a pathologist who has broad experience and expertise in the condition you’ve been diagnosed with can change or confirm your diagnosis and potential treatment options. Consider this PinnacleCare case:
A PinnacleCare member reached out when his wife was diagnosed with breast cancer, and it was suggested that she quickly undergo a bilateral mastectomy followed by chemotherapy. PinnacleCare arranged a second opinion with a top breast cancer specialist who had their pathology team review the tissue slides. The team came back with a diagnosis of atypical ductal hyperplasia, an abnormal cell growth that puts women at higher risk for breast cancer but is not cancerous itself. The mastectomy was canceled and instead the patient had an outpatient lumpectomy to remove all suspicious tissue and make a final and determinative pathology diagnosis. Not only did she avoid unnecessary surgery and chemotherapy, but she also avoided the cost and anxiety of cancer surveillance for a lifetime.
The experience of the pathologist can have a significant effect on the accuracy of the diagnosis. One study highlighting both the value of second opinions and the importance of the training and experience of the pathologist focused on diagnostic pathology for melanoma. Researchers found that getting a second opinion from a pathologist who is board certified or fellowship trained in dermatopathology improved the accuracy of the diagnosis. They compared the diagnostic classifications of biopsies by general pathologists and dermatopathologists and found that the highest rate of misclassification occurred when the pathologists did not have subspecialty training.
Getting a second opinion from an experienced, specialty trained pathologist
In most cases, pathology second opinions are done remotely. To ensure you provide everything the consulting pathologist will need to deliver a second opinion, contact the pathology department and ask what reports and samples are needed. Your PinnacleCare Health Advisor can not only help you gather and securely provide this information, your Health Advisor can also help you find a pathology specialist who’s experienced with diagnoses like yours.
In some cases, you may want to consider providing the pathologist who’s delivering the second opinion with only the samples, images, and other foundational material used to make your initial diagnosis. A randomized study by researchers at UCLA found that when provided with the diagnosis from the first opinion, the pathologists’ assessments were influenced by that first opinion, leading to an inaccurate diagnosis.
In addition to connecting you to experienced specialists for in-person or virtual second opinions, your Health Advisor can also help you with the next steps. If the second opinion confirms your diagnosis and treatment plan, your Health Advisor can provide evidence-based answers to questions about your condition or treatment and help you choose an experienced specialist to provide the treatment.
If your second opinion changes your diagnosis, suggests a different treatment, or changes which doctor you choose to provide your care, your Health Advisor can help you understand and weigh your options using evidence-based information and even arrange another opinion if you’d like the input of other experienced specialists before making a decision.
If the second opinion differs from the first, you can gather more information by talking with the providers who provided both opinions and asking several key questions:
- What clinical guidelines or evidence-based research support your diagnosis and/or treatment plan?
- Is there another diagnosis that could also fit my symptoms and the results of my diagnostic testing?
- Is there additional testing that could clarify my diagnosis?
There is time to get a second opinion
Many people have concerns about seeking a second opinion. When people are diagnosed with a serious condition, they feel they need to start treatment right away to achieve the best outcome. In most cases, however, unless you’re facing an emergency, you do not need to start treatment immediately and can safely take the time needed to get a second opinion.
In fact, studies have found that cancer patients who get second opinions benefit from taking the time to seek them. One study found that 43% women diagnosed with breast cancer who sought a second opinion at a National Cancer Institute-designated cancer center with tumor board received a change in diagnosis. Another study of people diagnosed with diffuse large B-cell lymphoma found that a second opinion changed the staging for 36% of these patients, which can affect the choice of treatment.
Get expert support from PinnacleCare
Connect with the PinnacleCare team to learn more about how we help our members navigate a serious diagnosis and other health needs.
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