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Next Steps After a Breast Cancer Diagnosis

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Step 2: Decide If You Need a Second Opinion

We’ve all heard the mantra: Get a second opinion. Still, only about 20 percent of women seek one, according to a recent study of almost 2,000 breast cancer patients. Even more surprising, many experts think that’s okay: “It’s outdated to insist a second opinion is always essential. Today, if a woman is being treated at a top-notch cancer center and she feels good about the specialists she’s seeing, a second opinion just may not be necessary,” says Megan Baker Ruppel, M.D., medical director of the comprehensive breast care program at Hollings Cancer Center at the Medical University of South Carolina in Charleston.

Consider sticking with one opinion if…

Your surgeon is associated with a National Cancer Institute-designated comprehensive cancer center. These centers offer a broad range of up-to-date treatment options, psychological support services and complementary and alternative therapies. And, most important, they foster close cooperation and communication among all the members of your cancer care “team,” which may include a surgical oncologist (your surgeon); medical oncologist (the doctor who oversees chemo, hormone therapy, and all other meds); radiation oncologist (administers radiation therapy); pathologist (prepares the lab reports on your tissue samples); and plastic surgeon (performs breast reconstruction). Search “NCI-Designated Cancer Centers” at cancer.gov or call 1-800-4-CANCER for a nationwide list. You can probably safely skip seeing more doctors if you feel confident you have all the information you need to choose a course of treatment.

But you may need a second opinion if…

You’ll be treated at a local hospital that doesn’t specialize in breast cancer. Many community-based hospitals do have excellent multidisciplinary teams, says Dr. Baker Ruppel. One of your doctors (usually your surgeon) helps connect you with the other physicians needed for your treatment. These specialists have weekly conferences to discuss breast cancer cases, so you’re assured your treatment plan is being assessed by multiple experts. It’s a good sign if the team practices at a hospital with a cancer program accredited by the American College of Surgeons (click “Find an Accredited Cancer Program Near You” at facs.org/cancer). But if your local doctors treat many other cancer types as well, consider traveling to a larger comprehensive center affiliated with the NCI or to an academic medical center for a consultation. Chances are it will help confirm the information you’ve heard. If the second opinion happens to differ, you may decide to switch doctors, go for a third opinion, or use the new advice to guide the care you receive at your local hospital.

A second opinion is strongly encouraged if…

The surgeon you’ve seen doesn’t work with a team and doesn’t practice at a hospital with an accredited cancer program. Several studies suggest that breast cancer patients have a higher likelihood of survival if they are treated by experienced surgeons at hospitals with a large volume of breast cancer patients.

You’re confused about the approach being discussed. You should not feel pressured by your doctor to choose a particular course of action, be offered only one type of treatment, or have doubts about any aspect of the diagnosis or treatment plan you’ve been presented. “In these circumstances there is no question that it’s in your best interest to get a second opinion,” says Dr. Lee. “You need to be confident that you’re receiving the best care possible.” The American Cancer Society (cancer.org or 1-800-227-2345) can provide referrals to comprehensive cancer centers near you.

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35 comments

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11:07AM PDT on Jul 21, 2014

Thank you :)

1:03PM PST on Feb 2, 2014

Interesting if conventional info. Like someone said, maybe we should clean up our food, air and water and maybe that would be a good help. Thanks.

12:58PM PST on Feb 2, 2014

Thank you for the post.

3:28AM PST on Dec 31, 2013

Noted

9:45PM PDT on Sep 4, 2013

Thank you :)

2:21PM PST on Jan 4, 2012

Sounds like the same old crap to me. I think it's about time we thought more lenier...really...HELLO...same treatment since my aunt in the early 70's..is this really the best we can do...mutilating women...poising them after to the point they need support groups? Let's clean up our food.

5:42PM PST on Dec 3, 2011

Do you know the date you really started to live your life? That date for me was May1,2006. The day of THE LUMP! I found it myself -- knew it was cancer before the doctor told me I was positive for breast cancer. By the time I saw the surgeon, my life had already taken a turn in a direction I never thought possible. I became involved in my treatment -- surgery, chemo-therapy -- these were not going to get the better of me -- I would not allow it!!! When everyone thought I would just sit back -- I stood up, ran for the door and didn't stop. Still going strong, I am still involved by helping others in their fight to win by volunteering at anything I can; breast cancer walks, runs, bake sales, just holding onto another girl's hand when needed. So see, In doing these things, I did not help myself, I was helping others. And I started to live the life I wanted -- a LIFE worthy of mention in the end. -- a LIFE to proud of. I am no longer the "girl with cancer" I became the Survivor who found herself just when she thought life was over. LIFE -- GO LIVE IT!!!

3:25AM PDT on Oct 15, 2011

self check,mammograms,regular check-ups,early detection.....my favorite word is benign.

9:53PM PDT on Oct 14, 2011

Excellent article and advice for everyone. Thanks

11:51AM PDT on Oct 14, 2011

I am a five-year survivor of breast cancer who did the "cut, poison, burn" therapy. I was fine throughout treatment and I'm fine today. Not dead. No side effects during or after treatment. My oncologist never told me I was "cured". I'm cancer free, I'm living with no evidence of disease but not cured. When I was diagnosed, I chose to delay my surgery for 2 1/2 months because of a prior commitment. Even though I had always lived a healthy lifestyle, during this 2 1/2 months I made some significant changes to my diet, took supplements that were supposed to shrink the tumor and the list goes on. I was hopeful - maybe it would work. But the tumor grew....

I have met many amazing breast cancer survivors, from 2 years to 25 years - women and men - who have undergone "orthodox" treatment. Like me, they're fine. Living life. No more cancer. No horrible side effects.

Susan L. - I'm curious... where are you getting the tests done that show your cancer is going away? Surely not from the medical system that you show such contempt for. Just sayin'...

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
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