The impact of patient-initiated subspecialty review on patient care Journal Article
| Authors: | Coffey, K.; Mango, V.; Keating, D. M.; Morris, E. A.; D'Alessio, D. |
| Article Title: | The impact of patient-initiated subspecialty review on patient care |
| Abstract: | Purpose: To determine the effect of subspecialty review of breast imaging on patients without a diagnosis of breast cancer who self-referred for a second opinion. Methods: Institutional review board–approved retrospective review was performed of 415 breast imaging studies submitted to our cancer center for second-opinion review by 245 patients in 2014, excluding cases without follow-up or change in original BI-RADS 0 assessment. One hundred forty-seven patients with 176 lesions were included. Original and second-opinion interpretations and recommendations were compared with histopathology or follow-up imaging. Results: Ninety-six of 176 (55%) lesions were reported as suspicious in the original interpretation. Second-opinion review was discordant with the original interpretation in 82 of 176 (47%) lesions. Second-opinion review downgraded 24 of 96 (25%) lesions originally reported as suspicious to benign or probably benign, averting biopsy of these lesions. Second-opinion review upgraded 31 of 80 (39%) lesions originally reported as benign or probably benign to suspicious. A total of 87 lesions were biopsied yielding malignancy in 23 (26%) biopsies. Twenty-eight of 87 (32%) biopsies performed were recommended after second-opinion review, with 8 of 28 (29%) of these biopsies yielding cancer. Eight of 23 (35%) cancers detected represented malignancy not initially detected in the original interpretation. Conclusion: Second-opinion review is valuable in patients pursuing a breast imaging specialist's opinion, even before they are diagnosed with breast cancer. Second-opinion review disagreed with the original interpretation for 47% of lesions, averted 25% of originally recommended biopsies, and detected cancer in 29% of additional biopsies recommended. Thirty-five percent of cancers diagnosed after second-opinion review were not initially detected in the original interpretation. © 2018 American College of Radiology |
| Keywords: | breast cancer; biopsy; cancer center; second opinion |
| Journal Title: | Journal of the American College of Radiology |
| Volume: | 15 |
| Issue: | 8 |
| ISSN: | 1546-1440 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2018-08-01 |
| Start Page: | 1109 |
| End Page: | 1115 |
| Language: | English |
| DOI: | 10.1016/j.jacr.2018.05.008 |
| PROVIDER: | scopus |
| PUBMED: | 30078435 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2018 -- Source: Scopus |
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