You Don’t Need To Rush To The Operating Room Following A Diagnosis of Breast Cancer

Most women probably don’t think twice what happens to their biopsy between the time it’s taken and the time the oncologist calls you with the results. Well, it’s the pathologist who “reads” the biopsy. He/she determines whether it’s malignant or benign. In 2006 the Komen Foundation released a study that estimated that in 90,000 cases, women who receive a diagnosis of noninvasive or invasive breast cancer either did not have the disease or their pathologist made another error that resulted in incorrect treatment. That’s almost 50% of all breast cancer diagnoses! Reading breast cancer biopsies is no easy feat. These are just tiny slivers of tissue. Indeed, Dr. Shahla Masood, the head of pathology at the University of South Florida, said in an article published  this week in the NY Times, “there are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin.” This is serious stuff, ladies. Heads or tails that leads to unnecessary disfiguring surgery, and life-threatening chemotherapy and radiation. By the way, gentlemen, as I’ve discussed in many blogs, the same problems affect prostate cancer diagnosis.

Concerned about the accuracy of breast pathology, the governing board for pathologists, the College of American Pathologists, said it would start a voluntary certification program for pathologists who read breast tissue. Among its requirements is that the pathologists must read 250 breast cases a year.

The take-home message is, don’t rush to the operating room if you’ve been diagnosed with breast cancer (the same message holds true for most other cancers). Be sure you get a second opinion from another pathologist who “reads” at least 250 cases of breast cancer a year. Ask your doctor for a recommendation. Even if your insurance doesn’t cover it, it doesn’t cost much to have it done. My sister-in-law got a second opinion from one of the world’s most renowned breast cancer pathologists for $350. Her biopsy was misdiagnosed, it was negative-it was the best $350 she ever spent.


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