31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 25 — Unbiased 2nd PATHOLOGY opinion is a MUST

Did you know…

Aggressive treatments for DCIS are based on pathology — and 25% may be wrong.

This happened to me.

I had several opinions and 3 different pathology reports. My gut told me something was not right and I needed to keep investigating.

Luckily I was referred to expert pathologist, Dr. Michael Lagios. He reassured me all the DCIS tissue removed from my breast was in fact LOW GRADE with NO necrosis. This differed from my original pathology report which stated “intermediate” grade. Two other pathology reports from major medical institutions also stated intermediate and one even said “intermediate-high grade with necrosis.”

While every person’s situation is individual, I thought, not everyone can afford the $600 out of pocket fee for an unbiased expert 2nd pathology opinion. I asked Dr. Lagios for his permission to post my recorded consultation with him so women and their loved ones could benefit from my questions and his answers:

Listen to My Phone Consultation with Dr. Michael Lagios

Unfortunately Dr. Lagios recently retired. I asked for his recommendation for a specialist in breast pathology. He recommended Dr. Jean Simpson

From Dr. Lagios’s website:

The Importance of a Pathology 2nd Opinion in Breast Cancer

Treatment decisions for breast cancer and their likely success are critically dependent on the analysis of the pathologist which is summarized in the pathology diagnosis.  As a colleague once put it, “The diagnosis is like an architect’s drawing: if it is faulty, the house will collapse.”

​Unfortunately, inadvertent errors in interpretation, either for the actual diagnosis of carcinoma, or in evaluating size, stage and margins, are commonplace. The National Cancer Institute (NCI) and the American Cancer Society (ACS) strongly recommend a pathology review of the pathology slides, particularly for duct carcinoma in situ (DCIS) and other non-invasive lesions, for which the error rate on review may be as high as 25 percent. A second opinion may make the difference between a diagnosis of benign hyperplasia or an in situ carcinoma, and the need for re-excision, radiation therapy and/or chemotherapy. Second opinions can also help by confirming a diagnosis and providing reassurance that the patient is making a reasonable choice.

For a pathology second opinion to be of maximal value, it must be based on direct re-examination of the pathology slides used for the original diagnosis. In the course of making a therapeutic decision of their breast cancer far too many women receive second opinions merely based on review of the written reports. With many new breast cancers of minute size or those which are entirely non-invasive, the issue of a direct review of the diagnostic materials becomes even more critical.”


Thanks to my dear friend Sandie Walters who told me about Dr. Lagios and that she learned about the importance of a 2nd pathology opinion from Dr. Susan Love. Here is one of my very first blog posts Dec. 30, 2011: 2nd Opinions Matter!!!

Thank you Dr. Susan Love for helping women better understand and navigate a DCIS diagnosis!!

About Donna Pinto

I am originally from New Jersey and moved to Los Angeles with my family at age 12. After graduating from San Diego State University with a BA in Journalism, I had a short-stint in magazine advertising sales before landing my "dream job" with Club Med. For two years I worked at resorts in Mexico, The Bahamas, The Dominican Republic and Colorado. My husband Glenn & I met in Ixtapa, Mexico and we embarked on a two year honeymoon around the world. This was also a research project for a book we wrote called "When The Travel Bug Bites: Creative Ways to Earn, Save and Stay Abroad." I am also the author of a quote book for new graduates -- "Cheatnotes on Life: Lessons From The Classroom of Life." In 1997, we settled in San Diego and I was blessed to work part-time from home for non-profit organizations while raising our two boys. In 2010, a DCIS diagnosis changed my life. DCIS 411 is the culmination of my on-going journey and discoveries.
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