Getting a second opinion

After a breast cancer diagnosisinfo-icon, you may feel like you need to make treatment decisions quickly, but in most cases breast cancer is not an emergency. Taking time to get a second opinion from another doctor can help you

  • feel more confident about the planned treatment
  • learn about other breast cancer treatment options
  • better understand the treatment options because you hear about them in a different way

Ask your doctor how much time you should take to decide. Don’t worry that your doctor will feel insulted by you seeking a second opinion. Most doctors favor it and know that a second opinion can benefit your care.

What is a second opinion?

A second opinion consultation is a meeting with a doctor you haven’t seen for your current breast cancer diagnosis and treatment plan. The second opinion doctor can be from the same practice as your current doctor, another local practice, or from an academic medical center.

The second opinion doctor will review your medical records, examine you, and may suggest additional testing. After that, you will discuss what the doctor recommends for treatment.

Before you see a doctor for a second opinion on breast cancer treatment, you might want to have a pathology second opinion to verify the details of your pathology report. Your pathology reportinfo-icon includes information from the biopsies and surgeries you may have had, such as the type of breast cancer, where it is located, and its stageinfo-icon, size, and gradeinfo-icon. Having a second look may help ensure you get the care you need.

When you get a second opinion for your breast cancer diagnosis or treatment, your doctor may also request a pathology second opinion. This is more likely if you get your second opinion at an academic medical center.

Just as you would take time to compare your options before making a major purchase or career decision, taking a little time for a second opinion can assist you in making careful choices about your breast cancer treatment.

Getting a second opinion can help you

  • confirm your diagnosis (stage or type of breast cancer may change)
  • learn more about the cancer
  • get another doctor’s thoughts on treatment options
  • find out about clinical trials available for your diagnosis
  • find a treatment or cancer center and doctors that you are more comfortable with

When should I get a second opinion?

It’s useful to get a second opinion

  • when you are first diagnosed with breast cancer

    • usually after getting the pathology report, but before starting any treatment, including surgeryinfo-icon
  • if test results are uncertain
  • to see a breast cancer specialistinfo-icon
  • to see a fertilityinfo-icon specialist
  • if disease returns
  • if treatment stops working and new treatment, or no treatment, is suggested
  • when you feel unsatisfied with your care, treatment, or answers you are getting from your doctors

How do I ask for a second opinion?

You can ask your oncologistinfo-icon or another doctor to refer you for a second opinion. If you have a specific concern, such as wanting to find clinicalinfo-icon trials for your type of breast cancer or protecting your ability to get pregnant in the future, mention that.

You may feel more comfortable asking for a referralinfo-icon if you say: “I appreciate your guidance and I want to be sure I explore all my choices before beginning treatment. Who can you recommend I see for a second opinion?”

Even if your doctor suggests someone, you are not obligated to consult that person. But you should always let your doctor know if you are going to get a second opinion before treatment.

You can also look for a referral on your own. Many cancer centers and hospitals will connect you to their doctors who do second opinions. A few have second opinion services available online.

Breast cancer organizations and medical associations may be able to help. Family, friends, and other people diagnosed with breast cancer might have suggestions. Remember that your treatment needs may be different than theirs. Check the background of all doctors suggested to you.

Will my insurance cover a second opinion?

Most private and public insurance plans cover second opinions for treatment. Some insurance companies require that you have a second opinion consultation before they will cover treatment expenses.

Be sure to contact your insurer to find out if second opinions are covered under your plan. Make sure to check what doctors are in your insurance network. Insurers may require you to pay more to see doctors out of your network.

What are my next steps after a second opinion?

In many cases, the second opinion will match or closely match your original doctor’s recommendation. Having the second opinion gives you peace of mind that you did your research and made a good decision.

Sometimes, the opinions don’t match. In this case, you may need to decide whether to work with your original doctor or to go to the new doctor. In either case, with your permission, your second-opinion doctor may get in touch with your original doctor to share the opinion and to discuss your case.

It can be stressful when opinions differ, especially if you prefer your original doctor. Talk with your provider about how you’re feeling. Consider asking for information about why the opinions may differ. Some questions to ask both doctors:

  • What did clinical trials show about these treatment options in people with cancers like mine?
  • Do outcomes vary based on these treatments, or do they work equally well?
  • Are there differences in the side effects of these treatments?
  • Would you feel comfortable giving me the other treatment? Why or why not?

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August 31, 2015
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