Second Opinion from Cancer Center Yielded Valuable Information for Breast Cancer Management

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A change in diagnosis was often the result of review by a multidisciplinary tumor board at the NCI-designated cancer center.
A change in diagnosis was often the result of review by a multidisciplinary tumor board at the NCI-designated cancer center.

As many as 4 in 10 women with breast cancer referred to a National Cancer Institute (NCI)-designated cancer center for a second opinion ultimately had a change in diagnosis, according to a recent study.1

This change in diagnosis was the result of review by a multidisciplinary tumor board at the cancer center.

“The treatment of breast cancer often involves not just surgery but chemotherapy, radiation, or hormonal therapy; it's highly coordinated care,” Nancy Klauber-DeMore, MD, FACS, of Medical University of South Carolina (MUSC) in Charleston, told Cancer Therapy Advisor. “With a tumor board, everyone involved in each patient's care can be sitting in 1 room discussing the case.”

The multidisciplinary team can include a surgical oncologist, medical oncologist, radiation oncologist, radiologist, pathologist, genetic counselor, clinical trials nurse, nurse coordinator, and other specialist clinicians.

In this retrospective study, Dr Klauber-DeMore and colleagues reviewed data from 70 patients referred for a second opinion to MUSC between August 2015 and March 2016. Reports from the referring institutions were compared with MUSC reports.

Of the 70 cases, 25 had additional biopsies performed with new cancers found in 16 patients, or 22.8% of the total population. Additionally, 20% of patients had a change in pathology interpretation during the second opinion evaluation.

After a complete workup, 42.8% of patients had a change in diagnosis as a result of the tumor board review.

These results really emphasize the importance of seeking a second opinion at an institution with a multidisciplinary tumor board, according to Dr Klauber-DeMore. All NCI-designated cancer centers, and probably most academic centers, have multidisciplinary tumor boards, she said. However, they are seen less commonly at community centers.

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