It was November 3, 2011 when I had a phone consultation with Dr. Michael D. Lagios, a nationally recognized breast pathologist and medical director of The Breast Cancer Consultation Service. As I wrote about in “Donna’s Journey,” the information I learned from Dr. Lagios gave me tremendous peace of mind (being that he downgraded the DCIS removed from my breast from intermediate grade to low grade). At the same time, I was totally shocked and in disbelief at the options he was telling me I had.
I recently listened back to the recording and I asked Dr. Lagios if he would be okay with me sharing it — so that other women may benefit from my questions and his answers.
I am as grateful now to him as I was then. Here is our 43 minute discussion of his review of my pathology slides, his recommended course of action for me and his perspectives on tamoxifen (which can also be found on his website here.)
Thank you Dr. Lagios for all you do to help women make the most informed decisions regarding an extremely challenging situation.
For more information on Dr. Lagios, visit his website:
The Breast Cancer Consultation Service is designed to provide self-referred women with newly diagnosed breast carcinomas, both invasive and in situ and/or atypical hyperplasias or atypia with a formal written review of their pathology slides, mammograms and other imaging studies. No physician referral or permission is needed to access the service.
The Breast Cancer Consultation Service provides:
- A review of your actual pathology slides, original mammograms and localization studies, breast ultrasound, specimen radiograms and breast MRI images.
- A second opinion regarding your pathologic diagnosis with an evaluation of your treatment options and their likely benefit.
- A formal report prepared for you and your designated physicians
- A 45-minute discussion of the findings, either in person or via telephone conference call for you, your support people, and designated physicians, if you desire.
Dr. Michael D. Lagios, a nationally recognized breast pathologist and medical director of The Breast Cancer Consultation Service, provides the service and personally discusses the findings with you. He has directed this and similar services in San Francisco since 1980. Dr Lagios is an internationally recognized expert on duct carcinoma in situ and has written or co-authored much of the pertinent literature in this area over the last 30 years.
DCIS 411 
Thanks so much for posting your conversation with Dr. Lagios. It’s so informative, and a huge gift from you and Dr. Lagios, to share this very personal conversation.
I also enlisted Dr. Lagios’ professional advice, as a second opinion on slides from a core needle biopsy. Like you, I had an extremely positive experience interacting with Dr. Lagios and his wonderful office staff. He reviewed my slides carefully, and took great care in commenting on my individual situation. At that time, being treated as an individual – rather than a statistic – was such a relief to me, and so empowering as well.
For anyone told they have ADH or DCIS (which are very subtle to diagnose and grade), I would highly recommend enlisting Dr. Lagios’ advice. No matter what one decides regarding treatment – be it active surveillance or more aggressive intervention – it’s important to know you’re making your treatment decisions based on a well-informed understanding of your diagnosis. For me, consulting Dr. Lagios made a world of difference.
best,
JG
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Thank you so much for posting this phone consultation and giving all of us a chance to actually hear the voice of Dr. Lagios if any of us ever need his services. It was great to hear that he doesn’t recommend radiation for low grade DCIS, whereas it seems that nearly everything I have read indicates that most doctors automatically put women with low grade DCIS through several weeks of radiation. I was also interested to hear his other recommendations such as Dr. Silverstein and also the City of Hope for an MRI, etc.
It would be great if all of us out here could avail ourselves of the best and most up-to-date facilities and physicians. Unfortunately, most of us are limited by our insurance. I’m in an HMO and therefore have no idea whether I would be able to utilize sources outside my HMO area, it would probably all be out of pocket and I would not be able to afford that, so there are some unfortunate practical elements to consider that limits access to the best options. However, I definitely feel Dr. Lagios’ second opinion pathology service, even paying out of pocket for his fee, is WELL worth it for the peace of mind you gained, obtaining the Van Nuys evaluation, which downgraded you from medium to low grade DCIS, plus his recommendation against tamoxifen, particularly at your age, as he said, it’s like jumping over a cliff and bringing on premature menopause. Thank you again for sharing this conversation, it is so appreciated and valued by everyone here who is struggling with these difficult decisions, at various levels. We are blessed to have YOU! .
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Thank you so much for giving us a chance to hear this. I will definitely contact him with second opinion. May God richly bless you Donna.
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Hi there and thank you for your indicated involvement in giving us valuable information on DCIS. I have a consultation with Dr. Lagios this coming Thurs and was wondering what is the best way to record our conversation. I’ve explore some apps available for my iPhone but did not what to pay for an app that wants to keep billing me on an yearly basis whether I use it or not. I just want to record one call one hour long. I am not a tech-y person. Any suggestions will be helpful and greatly appreciated. Thank you in advance.
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Hi there. I recorded my conversation with Dr. Lagios on a small handheld voice recorder. You can buy one at Best Buy for about $50. Or if you have a land-line, you can record from your voice memos on your cell phone. Or borrow someone else’s cell phone for an hour! Hope your consultation with Dr. Lagios goes well! 🙂 Donna
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Thank you Donna for your speedy reply. Yes I have a landline too so I can use voice memo on my cell to record. That’s a great idea. And I want to thank you for your well wishes as well.
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THANK YOU DONNA!!!
I already contacted Dr. Lagio’s office today. I will be following up with him regarding a 2nd opinion for my treatment.
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How much did this second opinion cost?
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$600…that was 2011. You can now get a 2nd pathology opinion for less. see “resources” page or FAQ
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