Actress Rita Wilson attributes the early diagnosis of her breast cancer to the fact that she got a second opinion, a step that experts say is particularly important when the consequences of a medical test or treatment are serious.
Wilson revealed this week that she underwent a double mastectomy as treatment for invasive breast cancer, according to a statement in People Magazine. But her diagnosis came only after she sought a second opinion — her initial test result showed no cancer.
"I share this to educate others that a second opinion is critical to your health. You have nothing to lose if both opinions match up for the good, and everything to gain if something that was missed is found, which does happen," Wilson said in the statement. Wilson also sought a third opinion before undergoing her breast cancer treatment.
Dr. Ranit Mishori, an associate professor of family medicine at Georgetown University School of Medicine (who was not involved in treating Wilson), agreed about the importance of second opinions. In circumstances in which a diagnosis or treatment could have serious effects on a patient, seeking a second opinion may be necessary, she said.
"There are many opportunities where people should ask for a second opinion," such as when they want to confirm a cancer diagnosis, or are considering whether to have extensive surgery, Mishori said.
In particular, tests that might require a second opinion are those that rely on human interpretation, such as a mammogram or a magnetic resonance imaging (MRI) scan, Mishori said.
As with anything in life, "there are mistakes made" when experts interpret medical test results, Mishori said. A doctor's skill level, his or her years of experience, and the technology available could all be reasons why an error occurs, she said. [ 7 Medical Myths Even Doctors Believe ]
In addition, people might consider a second opinion if they continue to experience symptoms after a test result showed there was nothing wrong, Mishori said.
In fact, Mishori said, her own mother-in-law underwent an MRI for abdominal pain, and the test showed nothing wrong. But when the symptoms didn't go away, "we had someone else read the MRI, and he saw something that explains everything," Mishori said. "This is human error, and it happens."
However, this doesn't mean that people should question the results of every medical test result that they have. In fact, Mishori discourages people from seeking a second opinion if the consequences of a particular result are not overly serious. Every time a person seeks confirmation for a test, it takes up the patient's time and the doctor's time, and costs money. "We don't want to confirm and reconfirm everything," Mishori said.
But in the right circumstances, a second opinion is justified, and can lead to a change in a patient's treatment. For example, in a 2008 study, researchers at the University of Iowa Carver College of Medicine reviewed the pathology slides of more than 5,600 patients who were referred for treatment at the center. In about 2 percent of the cases, there was a major disagreement between the initial diagnosis and the second opinion, a disagreement that could change the patient's treatment or prognosis. In 9 percent of the cases, there were minor disagreements, the study found.
People should not worry about upsetting their doctors by getting a second opinion. It happens so frequently that doctors are used to it, Mishori said. "If the doctor's offended, you probably don't want to go to that doctor," Mishori said. "This is about you," she said.
Some people might feel that they need to seek treatment right away after a cancer diagnosis, instead of getting a second opinion. But "taking the time to learn about your disease, getting a second opinion or perhaps even a third opinion, and weighing your options is a very reasonable approach," the Patient Advocate Foundation (PFA) says. "Proactive decision making will give you a greater degree of control over your treatment."
Patients who seek a second opinion should let their first doctors know, Mishori said, and patients will usually need the initial medical tests for the second opinion. In some cases, the two doctors will talk to each other about the case. "It's a learning opportunity for everybody," Mishori said. "It shouldn't be an adversarial process."
When opinions differ and patients are left feeling unsure about what to do, they can speak with their primary care doctors, who can help them put the new information together with the patients' own values and their threshold for deciding on certain procedures. "Sometimes, that requires a four- or five-way conversation" among the doctors and the patient, Mishori said.
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