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Understanding
DCIS
- Causes of
DCIS
- Genetic
Testing
- Self
Advocacy
- Decisions
- Screening
- Getting a
Biopsy
- When DCIS
is Diagnosed
- Getting
a Second Opinion
- Psychological
Impact
- Understanding
Risk
- Treatment
Getting a Second Opinion on Your Pathology
You should ask for a second opinion from another pathologist for any discrepant diagnosis — that is, one in which the pathology does not reflect the expectation of either the surgeon or the radiologist. For example, you may have microcalcifications that are suspicious for malignancy. These may have been sampled but not described in the pathology report. This would be a discrepant report and you should not be reassured that you have a benign disease.
You should also request a second opinion when the disease described is of microscopic proportions and is interpreted as cancer. This is also important when the actual tissue sample is small and you are given a recommendation for more extensive surgery and/or treatment.
A second opinion from a medical oncologist, surgeon or radiation oncologist will do nothing to correct misinformation or wrongful diagnosis in a pathology report. Any misinformation in the pathology report will have to be corrected by a review from another pathologist.
If you had a biopsy because calcifications were present in one part of your breast, you will want to be sure that all of them were removed during the biopsy. An X-ray of the tissue that was removed, called a "specimen mammogram," should show the presence of all the calcifications seen in the mammogram you had before your surgery. After your breast is healed, you will need to have another mammogram so that you can be absolutely sure that no calcifications — or more DCIS or even a small amount of invasive breast cancer — remain.
Summary
Some DCIS lesions will turn into invasive cancer and others will
not. The lower the grade, the better the outcome is likely to be, although
having lower-grade lesions does not guarantee that they will not eventually
become cancerous. When treated, DCIS is not life-threatening. Untreated
DCIS can go on to become invasive, although in the majority of women it
does not. High-grade DCIS is more likely to become an invasive cancer,
but it is also the easiest to contain because it grows in a more continuous
pattern and tends to be confined to one area of the duct. Be clear about
your biopsy findings and talk them over with your doctor. If your biopsy
shows DCIS, consider a pathology second opinion for the biopsy, and get
information from credible health resources.
