The review included 70 patients seeking second opinions. A total of 30 additional biopsies were performed for 25 patients, with new cancers identified in 16 patients. Overall, 16 or 22.8 percent of the 70 of patients had additional cancers diagnosed (either in the same breast, the contralateral breast or a metastasis to an axillary lymph node).

"Those findings would drastically change care," she said. "In addition, we found the pathology review changed in 20 percent of people. And 16 percent of people who met guidelines for genetic testing by the National Comprehensive Cancer Network (NCCN) guidelines for genetic testing had not been referred for testing."


In other areas of the nation where similar studies were done, the percentage of change in diagnosis resulting from second opinions was not as high as what was shown in this study. DeMore said this could be attributed to the higher level of rural areas in the state and that Hollings Cancer Center is the only NCI-Designated cancer center in the state, she said.

The S.C. Rural Health Association designates more than 75 percent of the state as rural.

In South Carolina, there are only three academic medical centers, which are centers with a hospital that works in conjunction with an academic institution. Less than 10 percent of the patients in the study who came for a second opinion had their first opinion at an academic medical center, DeMore commented.

"There are other states where there are many top medical centers available to patients," she said. "Whereas in our state, there are only a few places in the state that have this type of expertise. In this state, we are the only NCI-Designated Cancer Center, and MUSC has the only radiology residency program."

That means MUSC's radiology residency program has the leading experts in the field hired to teach the next generation, and they are doing research to set the next standard of care, she said.

"All of our radiologists at MUSC have done extra training with breast fellowships in breast imaging. All they do is breast imaging. The majority of our surgical oncologists have done surgical oncology fellowships, and the medical oncologists specialize in just breast medical oncology, and our pathologists have done fellowships in breast pathology. We're a center with really specialized care."

Many people may not know the level of specialty care when they seek care, and patients can be in a state of shock when they get a cancer diagnosis. "It's important to pause and regroup and make sure you have the right plan."

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