Second opinion on pathology report?

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Axolotl
Axolotl Member Posts: 56
edited February 2018 in IDC (Invasive Ductal Carcinoma)

Have any of you chosen to get a second opinion on your final pathology report? If so, what were your reasons and did it change anything?

I see that this can be done through Johns Hopkins. One reason I'm considering it is that I live in Asia and I'm just curious how another pathologist, particularly one based in the U.S., would interpret my slides.

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  • Lexica
    Lexica Member Posts: 259
    edited January 2018

    I actually just went for a second opinion on pathology at Hopkins. I haven't gotten the report back yet, but I will repost when I do. I had neoadjuvant chemo and it wasn't as effective as I'd hoped (which, I've since discovered, is fairly normal for my highly HR+ cancer). That was the main reason I went for a second opinion, but I also just wanted to see what another pathologists take on my slides would be. I don't think a second opinion is ever a bad idea.

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  • ps0705
    ps0705 Member Posts: 122
    edited January 2018

    Hi Axolotl,

    I'm sorry to hear of your diagnosis and it must be even more difficult to navigate everything if you are an ex-pat.

    I live in the US and just this week requested a second opinion on my path report from John Hopkins. The way I look at it is that I got a second (and third opinion) on my surgical course and all 3 agreed. That made me very comfortable with my tx plan.

    The reading and interpretation of the pathology is one of the driving forces for establishing your tx plan. So if you are able to, why not? You have nothing to lose and will hopefully gain comfort in your tx. plan. Will it help you sleep better at night knowing you got a second opinion or will you always wonder, what if I had? - that is what my surgeon said to me.

    My surgeon said it could go either way with mine after reviewing my surgical report from my mastectomy as to whether or not chemo would be recommended since my DCIS showed some microinvasion and that she supported me and would write a letter so it would be covered.

    Good luck with everything and with whatever you decide.


    .


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  • Axolotl
    Axolotl Member Posts: 56
    edited January 2018

    Thank you for your replies! I spoke with my MO yesterday and she's happy to help me get the second opinion from Johns Hopkins. She explained that there are some parts of the pathology that can be interpreted in more than one way, and it's possible another pathologist would see it differently.

    We are still waiting on the oncotype results; if they come back with an intermediate score I will probably go for the second opinion and/or Mammaprint, just to feel comfortable with the treatment plan.

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  • Maggie2
    Maggie2 Member Posts: 247
    edited February 2018

    I just met with the MO this past Friday. The initial biopsies had me as ER+/PR+.  Now he says I'm Triple Negative, The Ki67 is 5 and HER2 is 2-Equivical.  The MO is sending it for mammaprint and blueprint.  I have another appt with the MO in about 3 weeks to discuss the results. I don't know what to think, as most Triple Negatives did chemo and/or rads first, then surgery. I definitely want a second opinion after the mammaprint comes in.  Is having John Hopkins analyze the slides and results the gold standard, rather than seeing another local MO?

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  • LisaAlissa
    LisaAlissa Member Posts: 1,092
    edited February 2018

    There are a number of breast/cancer centers which do remote second opinions. John Hopkins is just one of them. Think M.D. Anderson, Duke, MSK also do second opinions--sure there are others as well. Your local docs may have a view about which one they'd be happiest working with.

    If a second opinion leads to a different treatment suggestion, sometimes that treatment can be administered locally.

    HTH,

    LisaAlissa

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  • Maggie2
    Maggie2 Member Posts: 247
    edited February 2018

    Thank you for the suggestions. I’ll look into these options

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