Second opinion in breast pathology: policy, practice and perception

Area of Science:

• Pathology
• Diagnostic Accuracy
• Medical Policy

Background:

• Second opinions are crucial in breast pathology for diagnostic confirmation.
• Understanding current practices and perceptions is vital for improving patient care.

Purpose of the Study:

• To evaluate laboratory policies, clinical practices, and pathologist perceptions regarding second opinions in US breast pathology.
• To identify variations in policies and the perceived value of second opinions.

Main Methods:

• A cross-sectional web-based survey was administered to 252 pathologists interpreting breast specimens across eight US states.
• Descriptive statistics were employed to analyze the collected data.

Main Results:

• Laboratory policies for second opinions varied by diagnosis, being most common for invasive cancer (65%) and ductal carcinoma in situ (DCIS) (56%).
• A significant majority (81%) obtained second opinions even without formal policies, believing they improve accuracy (96%) and reduce malpractice risk (83%).
• Pathologists perceived second opinions as easy to obtain and not diminishing their adequacy.

Conclusions:

• Breast pathology second opinion policies are inconsistent but prevalent for malignant and high-risk lesions.
• Pathologists demonstrate positive attitudes towards second opinions and integrate them into practice, irrespective of formal policies.
• Implementing supportive systems can aid pathologists in obtaining second opinions, particularly in settings lacking formal policies.