Second-opinion review of breast imaging at a cancer center: Is it worthwhile? Journal Article
| Authors: | Coffey, K.; D'Alessio, D.; Keating, D. M.; Morris, E. A. |
| Article Title: | Second-opinion review of breast imaging at a cancer center: Is it worthwhile? |
| Abstract: | OBJECTIVE. Second-opinion review of breast imaging studies can be a time-consuming and labor-intensive process. The purpose of this investigation was to determine whether reinterpretation of studies obtained at institutions outside a cancer center influences clinical management, specifically by revealing additional cancer and preventing unnecessary biopsy. MATERIALS AND METHODS. A review was conducted of breast imaging studies of 200 patients who underwent ultrasound and MRI at community facilities and had the images submitted for second opinions at a cancer center between January and April 2014. Each case was evaluated for concordance between the original report and the second-opinion interpretation. Second-opinion review resulting in the recommendation and performance of new biopsies was further subdivided into benign, high-risk, and malignant categories based on the histopathologic results obtained at the cancer center. RESULTS. Second-opinion review of the 200 cases showed a change in interpretation in 55 cases (28%; 95% CI, 21-34%). Overall, 26 recommendations (13%; 95% CI, 9-18%) led to a major change in management. Twenty new biopsies were performed, yielding 10 malignancies (5%; 95% CI, 2-9%) and four high-risk lesions (2%; 95% CI, 1-5%). Surgical management was changed to mastectomy for 6 of 10 patients (60%) with new sites of biopsy-proven malignancy. Eight biopsies were averted (4%; 95% CI, 2-8%) on the basis of benign interpretation of the imaging findings, and no disease was found at 1-year follow-up evaluation. CONCLUSION. Reinterpretation of studies obtained outside a cancer center resulted in a change in interpretation in more than one-fourth of submitted studies. Additional cancer was detected in 5% of patients, and biopsy was averted for 4%. The practice of second-opinion review influences clinical management and adds value to patient care. © American Roentgen Ray Society. |
| Keywords: | breast cancer; multimodality; second-opinion reinterpretation; subspecialization; second-opinion readings |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 208 |
| Issue: | 6 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 2017-06-01 |
| Start Page: | 1386 |
| End Page: | 1391 |
| Language: | English |
| DOI: | 10.2214/ajr.16.16871 |
| PROVIDER: | scopus |
| PUBMED: | 28301207 |
| PMCID: | PMC5588856 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 July 2017 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work