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Results of the Lynn Sage Second‐Opinion Program for local therapy in patients with breast carcinoma
Author(s) -
Clauson Jennifer,
Hsieh Y. C.,
Acharya Simbi,
Rademaker Alfred W.,
Morrow Monica
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10318
Subject(s) - medicine , second opinion , mastectomy , breast carcinoma , expert opinion , breast cancer , stage (stratigraphy) , carcinoma , general surgery , cancer , surgery , intensive care medicine , pathology , paleontology , biology
BACKGROUND The treatment options of breast conservation therapy (BCT) and immediate reconstruction for patients with carcinoma of the breast have not been adopted widely. The objectives of this study were to determine how often a second opinion on the local therapy of breast carcinoma changed patient management and to identify factors predictive of remaining at the second‐opinion site for therapy. METHODS Two hundred thirty‐one patients with intraductal carcinoma or Stage I and II breast carcinoma were reviewed retrospectively. At the time of the second opinion, patients completed a questionnaire regarding their initial surgical opinion and the reason for seeking consultation. RESULTS Only 46% of patients had a complete discussion of treatment options prior to the second opinion. The second opinion changed management in 54 patients (20.3%). The most common finding was eligibility for BCT in patients who were offered only mastectomy. Definitive local therapy occurred at the second‐opinion site in 65.8% of patients. The only predictors of remaining at the second‐opinion site were insurance type ( P = 0.008) and the patient's perception that options were not discussed at the initial opinion ( P < 0.001). CONCLUSIONS Second opinions provide useful information to patients and may change the management of their disease. They result in significant patient capture for an institution. Cancer 2002;94:889–94. © 2002 American Cancer Society. DOI 10.1002/cncr.10318