51% of 2nd-opinion reviews of breast imaging exams change interpretations

More than half of patients—51 percent—without a breast cancer diagnosis who were self-referred for a second opinion of imaging results received a change in radiologic interpretation, according to research published online June 28 in the Journal of the American College of Radiology.  

Researchers from the Memorial Sloan Kettering Cancer Center in New York found that 25 percent of lesions were downgraded to benign or most likely benign during second-opinion review. Because of this, 14 percent of patients did not undergo previously recommended biopsy, explained lead author Kristen Coffey, MD, and colleagues. 

Additionally, the researchers found that second-opinion review disagreed with the original interpretation for 47 percent of lesions and detected cancer in 29 percent of additional recommended biopsies. Also, 35 percent of cancers diagnosed because of second-opinion review were not detected in the original interpretation. 

Coffey and colleagues reviewed 425 breast imaging studies submitted to the Memorial Sloan Kettering Cancer Center for second-opinion review by 245 patients in 2014, according to the researchers. A total of 147 patients with 176 were included for analysis. 

Second-opinion review detected additional cancer in 4 percent of patients and prevented unnecessary surgery in 5 percent of patients, according to the researchers. 

"Second-opinion review is valuable in patients pursuing a breast imaging specialist’s opinion, even before they are diagnosed with breast cancer," Coffey et al. wrote. "Breast imaging specialists conducting second-opinion review of screening and diagnostic mammograms, ultrasounds, and MRIs at our cancer center identified 31 additional suspicious lesions, performed 28 additional biopsies and detected eight additional malignancies that were not initially detected in the original interpretation."