When to Get a Second Opinion: 3 Women with Breast Cancer Share Their Stories

Making decisions about your breast cancer treatments can be difficult, which is why it’s important to have a healthcare team you can trust. But when is it time to get a second opinion?

Throughout your experience with breast cancer, you’ll meet with many different healthcare professionals.

Some people may choose to stick with the team of doctors they have from the start. If your diagnosis and treatment are fairly straightforward and you’re comfortable with them, there may be no reason to talk with another doctor.

Other diagnoses may be more complex. Or you might just not feel like you have the best relationship or communication with your doctor. In these cases, getting a second opinion doesn’t hurt — and it may even be necessary to get the treatment you need.

Here are three stories that can help guide you to make the right decision.

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Finding the right team of doctors

• Name: Marci
• Age: 56
• Diagnosis: ER-positive, HER2-negative stage 1 breast cancer in 2018
• Treatment: mastectomy, followed up by prophylactic mastectomy and reconstruction
• Second opinions: several

Marci knew she might be susceptible to breast cancer, as both her mother and grandmother had it. But it was a long route for her to get the actual diagnosis, and it took her several doctor visits.

She first went to RUSH Oak Park Hospital in Illinois and had a mammogram there, which showed unusual tissue patterns. She went back and had an ultrasound and her first biopsy. All the results were negative, but because of her family history, her radiologist and general practitioner sent her to a breast surgeon at RUSH Chicago, where she had an MRI and a second biopsy. This time the results were positive, confirming her worst fears.

Marci said the surgeon was very warm and welcoming and even called her on a Friday night at 9 p.m. to talk about her diagnosis. Her doctor also welcomed any second opinions and even provided Marci with a list of other doctors she could consult with. Marci and her husband Steve opted for another opinion, this time at Northwestern Hospital in Chicago. She saw a team of doctors there — a surgeon, two different oncologists, and a plastic surgeon.

Still not getting the results she wanted, Marci went back to RUSH Chicago, this time meeting with a radiation oncologist and a plastic surgeon. But she didn’t totally feel comfortable with the overall teams at RUSH or Northwestern and wanted a third opinion.

She and Steve finally went to Cleveland Clinic and fell in love with the team of doctors there. She had all of her treatment there, including reconstruction. Because she opted for mastectomy instead of lumpectomy, she didn’t need chemo or radiation.

Marci’s advice to others about getting a second opinion is: Why not?

When working on a house, you get several quotes, she said. This is your life and your body. She also said she was scared “beyond belief” when getting the final opinions at Cleveland Clinic.

But she said it helped tremendously. “I would highly recommend anyone going through anything [like this] to get a second opinion,” she said.

“It is a team, you and your doctors,” she said. “It’s really important that you respect your doctors… that you jive with your doctors.” She added, “At the time, we all make decisions with the best information we have.”

A straightforward treatment plan and decision

• Name: Sonja
• Age: 55
• Diagnosis: ER-positive invasive ductal carcinoma, stage 2B, in 2017
• Treatment: bilateral mastectomy and reconstruction, underwent chemo but no radiation, currently taking the anti-estrogen pill
• Second opinions: none

When she received her diagnosis, Sonja wanted a second opinion. She wanted to “throw the kitchen sink at cancer,” fight it 100%, and get as much information as she could with multiple opinions.

But her husband, who is a neurologist at Northwestern Medicine in Chicago, had a big influence on her, “calming me down,” as she explains. His opinion was to wait and see what they were dealing with first — wait for the biopsy results, see if lymph nodes are affected, and find out the staging.

After her mastectomy, she learned she didn’t have any lymph node involvement, though she had four tumors in one breast.

Her treatment plan became very straightforward, she said, and they decided to follow the medical advice of her oncologist. Sonja and her husband didn’t even discuss the possibility of getting a second opinion with her doctor.

“If the diagnosis is straightforward, not in the lymph nodes, and the treatment is straightforward, there may not be a need to get a second opinion,” she said. She also had a very fast turnaround time: Only 3 weeks had gone by from diagnosis to mastectomy.

Her only regret is not having a different plastic surgeon. The healthcare network outside of Chicago she was participating in was very small, and she didn’t have many choices for plastic surgeons.

In addition, she also emphasized that it’s important to feel good with your doctor. “One thing I would caution people about is to realize that your oncologist is going to be with you for a long time,” Sonja said. “If you don’t have a good rapport, maybe you should go to someone else.”

The importance of communication and understanding

• Name: Kathleen
• Age: 57
• Diagnosis: ER-positive, HER2-negative, stage 3C breast cancer (initially) on July 1, 2016
• Treatment: unilateral mastectomy, chemo, radiation, and prophylactic mastectomy, had a recurrence on June 1, 2021, with bone metastases
• Second opinions: several

Nothing ever showed up in Kathleen’s yearly mammograms. The only indication of breast cancer was that her left nipple was growing inward. After a 20-minute ultrasound, her radiologist announced he saw a speck of cancer. That’s when the Pandora’s box began to open.

Kathleen’s original oncologist in 2016 oversaw her mastectomy, chemo, and radiation, but she wasn’t satisfied with her because the doctor was against any clinical trials, and she didn’t want Kathleen to get a prophylactic mastectomy.

After Kathleen went to Northwestern Hospital in Chicago to get expert counsel, she told her oncologist she had gotten a second opinion. Her doctor became very insulted, even though the Northwestern doctor simply confirmed the treatment. But at Northwestern, Kathleen also learned about a clinical trial involving the drug everolimus.

Kathleen chose to participate in the clinical trial despite her doctor’s protests. She also decided to switch doctors. It was, she says, one of the best decisions she ever made.

Her new doctor embraced clinical trials and was on her side regarding the second mastectomy. He told Kathleen about another clinical trial called the Breast Cancer Weight Loss trial, which was about weight loss and recurrence. Kathleen participated in that trial for 2 years with his help.

But she had a recurrence 5 years later. The cancer had traveled from her left breast to her right hip. She had only a little bit of bone metastases, and she opted for a second and third opinion to visit radiation oncologists at Northwestern and University of Chicago.

She talked to both experts about possible ablative radiation treatment for her bone metastases. Even though they both were against the idea, they made her understand why it would not be a good option for her at this time, and she felt very satisfied having visited them.

Her new oncologist embraced all of her extra visits to medical oncologists, radiation oncologists, and breast surgeons.

“I now have an online portal with all of my doctors represented. I feel I have a team of doctors working for me,” she explained. “I don’t feel like I am alone in my journey. I can message any of them and I will get a response from someone on their team. If the question is important enough, the nurse will ask the doctor. None of this would have happened if I had not gotten a second or third opinion.”