Second Opinions for Breast Cancer Treatment: Factors and Effects

Education, genetic testing, and interest in one’s treatment are all factors influencing whether a patient seeks a second opinion for breast cancer treatment, according to an article published in JAMA Oncology.¹

The availability of many treatment regimens for breast cancer, as well as the ever-increasing list of genetic biomarkers for which oncologists test, can make medical decision making difficult for patients, leading to second consultations. It is unclear, however, which factors influence patients to seek a second opinion, and whether second opinions tend to influence treatment decision making.

For this survey-based study, researchers identified 3880 patients with stage I or II breast cancer identified through the Surveillance, Epidemiology, and End Results (SEER) registries of Georgia and Los Angeles County, 1901 of which were included in the sample.

Nearly 10% (168) of patients solicited a second opinion; factors associated with solicitation included being college educated, frequently using online support groups, and a preference for making one’s own treatment decisions. Patients who had a variant of unknown significance (VUS) result on germline genetic tests were 3 times as likely to seek a second opinion.

Second opinions did not, however, appear to increase the likelihood of chemotherapy receipt.

The authors concluded that second opinions are likely to be solicited more often as genomic panels grow more complex. The study’s results indicate a need for oncologists to be better prepared to handle patient questions, particularly when genetic tests yield inconclusive results.

Reference

1. Kurian AW, Friese CR, Bondarenko I, et al. Second opinions from medical oncologists for early-stage breast cancer: prevalence, correlates, and consequences. JAMA Oncol. 2016 Dec 29. doi: 10.1001/jamaoncol.2016.5652 [Epub ahead of print]