Wednesday, January 17, 2007

US study looks at second opinions in breast cancer

WASHINGTON (Reuters) - Breast cancer patients were urged to change their treatment plans more than half the time when they received a second opinion from a team of specialists, U.S. researchers reported on Wednesday.

Overall, 52 percent of patients whose original diagnosis and treatment recommendations were taken to a multidisciplinary team were advised to make one or more changes in their treatment, the researchers at the University of Michigan Comprehensive Cancer Center found.

The changes were a result of breast imaging specialists reading a mammogram differently or breast pathologists interpreting biopsy results differently, the researchers reported in this week's issue of the journal Cancer.

The team, called a multidisciplinary tumor board, included surgeons, radiation oncologists, medical oncologists, radiologists and pathologists.

"A multidisciplinary tumor board that involves the collaborative effort of multiple medical specialties allows expert opinion and recommendations based on the most recent research findings," said Dr. Michael Sabel, a surgeon who worked on the study.

"Meanwhile, the patients come to only one setting, with no need to visit multiple specialists individually."

His team looked at the records of 149 breast cancer patients referred to the Cancer Center's multidisciplinary breast tumor board for a second opinion.

They found the original doctors often did not consider new surgery techniques, such as delivering chemotherapy before surgery to help save more of the breast, or sentinel lymph node biopsy, a new technique that helps find whether cancer has spread beyond the breast.

And radiologists reinterpreted imaging results in 45 percent of patients, in some cases identifying previously undiagnosed second cancers.

More than a quarter of patients were advised to have another biopsy.

Specialized breast pathologists made new interpretations of how aggressive a tumor, or what type of tumor it was, in 29 percent of patients, the researchers found.

More than 200,000 U.S. women will be diagnosed with breast cancer this year, according to the American Cancer Society, and 40,000 will die of it. Globally, 500,000 women die every year from breast cancer.

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