How to Get a Second Opinion About Your EBC
Sometimes, a breast cancer diagnosis isn’t clear-cut and treatment options may not be, either. A second opinion can help you decide a way forward that’s best for you.
What Is a Second Opinion?
Doctors often call for second opinions from each other when cases are complicated or hard to diagnose. Your getting a second opinion is no different. When you have a diagnosis that concerns you – such as breast cancer – talking with a doctor in another practice, clinic, or hospital can:
- Confirm your original doctor’s diagnosis and treatment plan
- Give additional information about your diagnosis or planned therapy
- Allow you to find a doctor who has more experience with your type of cancer or the kind of treatment you want
- Give you different treatment options to think about
Although many patients do, you shouldn’t worry about upsetting your doctor by wanting a second opinion. Doctors are used to patients doing this. It’s likely that your doctor will welcome confirmation from another doctor of their diagnosis and recommended therapy or the opportunity to consider other options for you.
When to Get a Second Opinion
Don’t be afraid to seek a second opinion at any time – at diagnosis, before or after surgery, and during your treatment or even after. Most people want a second opinion after they are diagnosed, but others are looking for newer or more effective therapies than what they’re currently getting. The more precise your diagnosis, the more effective your treatment will be. A second opinion can also help avoid overtreating your breast cancer, which can impact your quality of life.
Reasons to get a breast cancer second opinion include:
Before treatment
- You want to confirm the accuracy of your pathology report.
- You want to be sure you’re on the right course.
- You want to know all the options available to you.
- Your doctor is unable to make a definitive diagnosis.
- Your cancer is rare or unusual.
- Your doctor doesn’t specialize in breast cancer.
- Your treatment team is not sure of the stage of your cancer.
- You get few treatment options from your doctor.
- You are not able to understand your doctor because of a language barrier or medical jargon.
- Your insurance company requires a second opinion before you start treatment.
Before surgery
If you’re having surgery, you may have multiple imaging tests such MRIs, ultrasound, and mammograms to map the location and extent of your breast cancer. These tests also help surgeons suggest the type of procedure and postsurgical treatment that’s best for you. Getting a second radiology opinion on any of these imaging tests may be useful. You also may want a second opinion from a surgeon about the type of surgery you need, from a plastic surgeon about reconstructive options, or about the types of treatment recommended before surgery (neoadjuvant therapy).
During treatment
You may want to ask for a second opinion from a radiation or medical oncologist about any recommended treatments such as chemotherapy or radiation, hormonal therapies, and targeted therapies. All these treatments can vary because of your individual cancer profile and situation.
If you want a change in the approach to your treatment because it’s not working well, you’ve gotten other medical issues because of it, or you don’t like some aspect of your care, you may want to get another opinion.
After treatment
You might even choose to get a second opinion after your treatment is over. A second team can review your diagnosis and treatment to affirm your choices or provide additional advice.
How to Seek a Second Opinion
Tell your doctor you want to get a second opinion. They may be able to give you a referral for one. If you have just been diagnosed with breast cancer, your cancer doctor (oncologist) is probably new to you. You may feel like you don’t want to risk this new relationship by asking them to refer you to someone else, but don’t be.
Studies have shown that people were very satisfied when they chose to get a second opinion. They felt reassured about their diagnosis and treatment and gained greater knowledge. They also noted greater confidence in their original doctor after getting a second opinion.
If you’re still nervous, try these suggestions to start the conversation about getting a second opinion with your doctor:
- “I want to make sure I know and have thought about all my options. I’d like to get a second opinion. Can you help?”
- “I trust you and your expertise, but this is a life-changing diagnosis. Before going forward, I’d like to get a second opinion.”
- “I try not to make big life decisions based on one piece of advice. I want to get this right the first time, so I’d like to get a second opinion.”
- “I know you’ve probably gotten your colleagues’ opinions on my case and I appreciate that, but I’d like to talk to someone at another [hospital, clinic, office] who can confirm my diagnosis and treatment plan.”
Unfortunately, you may encounter the rare doctor who gets defensive or angry by your plan to get a second opinion. Be firm, and consider whether a doctor who acts this way is the right one for you.
Tips for Getting a Second Opinion
Do your research
In addition to asking your doctor for a referral, you may also be able to find a breast cancer specialist through your insurance provider. Local hospitals, clinics, and cancer centers are good resources, too. If you type “breast cancer second opinion” into a search engine, you can find academic medical centers that provide second opinions about your breast cancer pathology report.
You can also find doctors through credentialing agencies such as the American Board of Medical Specialties or the American Medical Association. The National Cancer Institute has a list of centers that provide the most up-to-date cancer treatments, including for breast cancer, which you can find by calling 800-4CANCER or 800-422-6237.
Get authorization
Contact your insurance company to see if they’ll pay for your second opinion and whether the second doctor needs to be in-network.
Gather your records
Ask which medical records the second doctor wants to review. You’ll need to ask your current doctor’s office to provide them. You may be able to download them through an online patient portal, if that’s an option. Your doctor’s office might ask you to sign a release to send your records out.
It’s important to give the doctor providing your second opinion the details needed to make an informed recommendation.
This can be quite a bit of information, so give the second doctor enough time to review your records before your visit so that your time and theirs can be used more effectively.
Plan your visit
Once you’ve found a doctor to give you a second opinion, make your appointment. You may even be able to schedule a virtual breast cancer second opinion.
Before your visit
- Think about what information you want to get out of your appointment.
- Make a list of all your questions.
- Write down your current symptoms and any prior treatment you’ve had.
- Have your own copy of your medical report to look at during the visit.
If possible, have a friend or family member go with you to write notes or to help you remember the information later.
Doctors sometimes forget not to use medical jargon. Ask your first and second opinion doctors to explain any terms you don’t understand.
Ask the doctor giving the second opinion whether they’re open to answering more questions or giving guidance in the future, even if you’re not their patient.
Post-visit follow up
After your visit, ask the second opinion doctor to write a report to send to your doctor and you. It might be helpful for the two doctors to talk, especially if the second opinion has information that may affect your treatment.
Do I Have Time for a Second Opinion?
A breast cancer diagnosis might make anyone want to dive into therapy right away. But there’s usually time to do research on your diagnosis and treatment plan as well as get a second opinion. Only rarely will you need to make treatment decisions immediately. If you’re worried about taking this time to research before treatment, talk to your doctor.
What Kinds of Questions Should I Ask?
It’s a good idea to be organized and on point when you’re getting a second opinion.
About your diagnosis
"Is my diagnosis as accurate and detailed as possible?" Doctors now understand the genetic origins of certain cancers such as breast cancer. Understanding the genetic basis of a cancer can determine treatment options. If there is genetic testing for your type of cancer and you haven’t had it, ask if you should.
About standard therapy
"What is the standard treatment for my type of breast cancer? And are there other options? What are the chances of success? What are the side effects?" It’s important to know the advantages and drawbacks of each type of therapy you’re thinking about.
If your current treatment isn’t progressing or has stopped working
Ask about clinical trials or emerging therapies you can consider. If you’re enrolled in a clinical trial, do you need to be a patient at that medical center or can they coordinate with your doctor?
About the doctor or facility where you’re seeking a second opinion
Just like you vetted your first doctor, you should do the same when seeking a second opinion. Among the questions you should ask:
- Is the doctor board certified?
- Has the facility met the standards of the National Accreditation Program for Breast Centers?
- How many mammograms does the facility do each year? How many breast cancer patients are diagnosed and treated there? How many breast cancer surgeries do they perform?
- Does the facility have a range of services that breast cancer patients require – surgery, medical oncology, radiology, radiation therapy, pathology, genetics?
- Do they participate in research and clinical trials?
- What kinds of outcomes do they have for breast cancer?
What If the Second Opinion Differs From Your First?
After you get a second opinion, make an appointment with your first doctor to discuss it.
As you discuss your diagnosis and treatment plan with both doctors, they may have different interpretations and recommendations. If that’s the case:
- Ask both doctors how your test results were interpreted.
- Make sure both explain how they decided on your treatment plan.
- Ask what studies or medical journals they consulted to arrive at a plan for your breast cancer.
- Ask what they’ve suggested to other patients with cases such as yours.
- Ask if the doctors will talk with one another about their findings.
- Consider seeking a third opinion. Depending on the area of disagreement, you might want to talk to another type of specialist – a pathologist, radiation oncologist, or surgeon – to hear what they have to say.
How Many Second Opinions Should I Get?
You should get as much information about your breast cancer diagnosis as you can. But it’s important to know when it’s time to stop looking for answers and make a decision. If you are getting a lot of second opinions just to get an answer you want, you may be defeating the purpose of getting one. A second opinion should help you get an accurate diagnosis or confirm one and figure out the best treatment for you.
Staying the Course
Cancer can be an emotional journey – and a long one – so you should have a doctor you trust.
If your original doctor is a breast cancer specialist, has the experience and know-how you need, and you feel good about going forward with their recommendations, you might not want or need a second opinion. And that’s OK, too. But you should still verify your doctor’s expertise and learn about your diagnosis and recommended treatment plan.
Takeaways
Getting a second opinion is OK and often beneficial. It can confirm what your first care team says or may offer a different interpretation. It may feel awkward to tell your first doctor you want a second opinion, but most doctors support patients getting more information about their conditions.
Show Sources
Photo Credit: monkeybusinessimages/Getty Images
SOURCES:
American Cancer Society: “Seeking a Second Opinion.”
BMJ Open: “Patient-initiated second medical consultations—patient characteristics and motivating factors, impact on care and satisfaction: a systematic review.”
Breastcancer.org: “When to Get a Second Opinion,” “Where Should I Go for a Second Opinion?” “What to Expect When Getting a Second Opinion,” “Getting a Second Opinion,” “Asking for a Second Opinion.”
Cancer Research UK: “Getting a second opinion.”
Cleveland Clinic: “Breast Cancer: Getting a Second Opinion.”
Johns Hopkins Medicine: “Get a Second Opinion.”
Keck Medicine of USC: “Why I’m Not Offended When My Patient Wants a Second Opinion.”
Komen.org: “Getting a Second Opinion,” “Talking with Your Doctor.”
Memorial Sloan Kettering Cancer Center: “Getting a Second Opinion After a Cancer Diagnosis: 9 Things To Know.”
Yale Medicine: “Can a Second Opinion Make a Difference?”
