2nd opinion

hi ellen1dg,

I live in RI and started all of this here at a local hospital because when I went for my yearly mamm, I never anticipated any issues.  Since the diagnosis, I have switched to Boston, I am at MGH now.  It was a bit of legwork, but worth it, I personally drove all my films up and the pathology slides from the biopsy were overnighted from the office in RI to MGH.  I continued on with the BRCA testing in RI (negative!) and just brought the test results w/me to MGH. 

It was easy enough and if it gives you peace of mind, then it's worth it.  I didn't necessarliy feel like I didn't trust my Dr. in RI, or that the results would be different if read at MGH, it was just for the course of action I am taking (doub mast/reconstruction in Dec) I felt that MGH was where I wanted to be.  My previous Dr was fine for what she told me, but I didn't feel like she was the right "fit" for me to develop a potentially long-term relationship with.

So I guess I am saying, a second opinion could be a good thing, also keep in mind that whatever type of treatment you choose (surveillence, tamox, surgery, etc) it is an important relationship to feel comfortable & confident with that Dr.

Good luck in your search if you choose to look futher, and feel free to PM me if you need anything.

Take care! 

I have classic LCIS, ALH, nothing worse, and a weak family history.  Reread of slides upgraded 'features of ALH' to 'ALH'; everything else was the same.

Re: genetic testing:  I had genetic counseling, but not testing.  When I had to submit my family tree, I only had to include my parents, sibs, neices and nephews, aunts, uncles, and grandparents, grandchildren.  At my place, they did not ask for my family tree farther away than that.  (No cousins, great-grandparents, etc.)  I don't know if other places do.

Here are the USPTF guidelines.  Some families have unusual patterns (such as few females or few members in a generation), so they may deserve more analysis from a genetics counselor.

These recommendations apply to women who have not received a diagnosis of breast or ovarian cancer. They do not apply to women with a family history of breast or ovarian cancer that includes a relative with a known deleterious mutation in BRCA1 or BRCA2 genes; these women should be referred for genetic counseling. These recommendations do not apply to men.

Although there currently are no standardized referral criteria, women with an increased-risk family history should be considered for genetic counseling to further evaluate their potential risks.

Certain specific family history patterns are associated with an increased risk for deleterious mutations in the BRCA1 or BRCA2 gene. Both maternal and paternal family histories are important. For non-Ashkenazi Jewish women, these patterns include 2 first-degree relatives with breast cancer, 1 of whom received the diagnosis at age 50 years or younger; a combination of 3 or more first- or second-degree relatives with breast cancer regardless of age at diagnosis; a combination of both breast and ovarian cancer among first- and second-degree relatives; a first-degree relative with bilateral breast cancer; a combination of 2 or more first- or second-degree relatives with ovarian cancer regardless of age at diagnosis; a first- or second-degree relative with both breast and ovarian cancer at any age; and a history of breast cancer in a male relative.

For women of Ashkenazi Jewish heritage, an increased-risk family history includes any first-degree relative (or 2 second-degree relatives on the same side of the family) with breast or ovarian cancer.

About 2 percent of adult women in the general population have an increased-risk family history as defined here. Women with none of these family history patterns have a low probability of having a deleterious mutation in BRCA1 or BRCA2 genes.http://www.uspreventiveservicestaskforce.org/uspstf05/brcagen/brcagenrs.htm#clinical