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Costs and benefits of obtaining a second opinion in oncology cases

R. C. Regan, K. M. Rassnick, E. K. Malone, S. P. McDonough

SECOND opinion histopathology is common practice in human medicine to confirm diagnoses and ensure that the patient is treated appropriately. Histopathology review has also been recommended for veterinary oncology. The aim of this prospective study was to investigate and validate a previously reported discordance rate in second opinion veterinary oncological pathology and determine its impact on cancer staging, treatment and prognosis. It also investigated the costs of obtaining a second opinion.

Fifty-two cases (48 dogs and four cats) that were referred to the oncology service at Cornell University College of Veterinary Medicine and had an initial biopsy diagnosis of neoplasia were prospectively enrolled in the study over a one-year period. Two to five unstained recut slides were submitted for a blinded second opinion from one of 11 different pathologists. All cases with major disagreements were reviewed by a third, blinded pathologist.

Diagnostic disagreement was found between the first and second opinions in 25 cases (48 per cent); 15 of 52 (29 per cent) of these discrepancies were partial diagnostic disagreements (ie, the underlying diagnosis was the same but some information, such as grade, margins or tumour subtype, was …

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