NCPA - National Center for Policy Analysis


January 3, 2007

Dr. Michael Sabel, a University of Michigan breast cancer surgeon, and author of a new study, finds that a team approach to cancer treatment provides more accurate assessments than serial doc-shopping for a second opinion, says Lauran Neergaard, an Associated Press Medical Writer. 

The team reviews are important because of the prevalence of inaccurate treatment assessments by individual doctors, says Neergaard.  In Sabel's study alone, of 149 breast cancer patients, half had their initial treatment changed when they sought a review, often for different reasons:

  • Sometimes it was because the original doctor didn't follow national treatment guidelines; 5 patients, for example, had been told to get a mastectomy when they were good candidates for breast-conserving lumpectomy instead.
  • Other times the original advice didn't take into account newer techniques, such as using chemotherapy to shrink the tumor before operating so the breast could be saved.
  • In other instances surgeons thought women were good lumpectomy candidates -- only to have an oncologist determine they couldn't tolerate the radiation that's required afterward, and these surgeons ended up recommending a mastectomy instead.
  • And in 29 percent of the patients, the Michigan pathologists interpreted biopsy results differently than the original doctors, leading to a change in diagnosis -- cancer instead of benign breast disease for one -- and a change in the aggressiveness of treatment.

Still, the question is whether everybody needs a second opinion, says Dr. Ted Gansler of the American Cancer Society -- especially if they originally sought care at one of the many hospitals officially designated by the National Cancer Institute or the American College of Surgeons as comprehensive cancer centers.

But anytime there's uncertainty about a diagnosis or best treatment, it's probably a good idea, he says.

Source: Lauren Neergaard, "Doctors back new approach on 2nd opinion," Yahoo News, January 3, 2007.


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