Analysis of Oncological Second Opinions in a Certified University Breast and Gynecological Cancer Center Regarding Consensus between the First and Second Opinion and Conformity with the Guidelines.

Breast cancer Certified cancer center Guideline conformity Gynecological oncology Oncology center Second opinion

Journal

Breast care (Basel, Switzerland)
ISSN: 1661-3791
Titre abrégé: Breast Care (Basel)
Pays: Switzerland
ID NLM: 101254060

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 18 01 2020
accepted: 03 06 2020
entrez: 12 7 2021
pubmed: 13 7 2021
medline: 13 7 2021
Statut: ppublish

Résumé

Oncological second opinions are becoming increasingly important in the era of complex treatments and established certified cancer centers. Oncological guidelines with the highest levels of evidence are available, but these can only be effective to the extent that they are implemented. Therefore, we analyzed the effects of second opinions with regard to their agreement with first opinions and conformity with guidelines. In 164 patients with a diagnosis of breast cancer or gynecological malignancy who requested a second opinion, the first and second opinions, established at the interdisciplinary tumor conference, and conformity with the guidelines were evaluated. The first opinion was not in agreement with the guidelines in 34.8% (15.2% diagnosis, 12.8% surgical therapy, 13.4% systemic therapy, and 5.5% radiotherapy), and the recommendations were optimized in the second opinion in 56.7% (28.7% diagnosis, 15.9% surgical therapy, 30.5% systemic therapy, and 8.5% radiotherapy). Oncological second opinions showed significant effects and one-third of first opinions were not in conformity with the guidelines. In a significant proportion of cases, the existing treatment plan was changed or supplemented to allow modern and individualized treatment approaches.

Identifiants

pubmed: 34248471
doi: 10.1159/000509127
pii: brc-0016-0291
pmc: PMC8248777
doi:

Types de publication

Journal Article

Langues

eng

Pagination

291-298

Informations de copyright

Copyright © 2020 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare.

Références

Geburtshilfe Frauenheilkd. 2018 Nov;78(11):1056-1088
pubmed: 30581198
Gesundheitswesen. 2017 Oct;79(10):871-874
pubmed: 27300100
Oncology. 2010;78(3-4):189-95
pubmed: 20414007
Oncol Res Treat. 2018;41(12):769-773
pubmed: 30458451
Ann Surg Oncol. 2002 Dec;9(10):982-7
pubmed: 12464590
JAMA. 2009 Oct 14;302(14):1551-6
pubmed: 19826024
Patient Educ Couns. 2019 May;102(5):998-1004
pubmed: 30581013
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2002 Mar;45(3):223-33
pubmed: 24676917
Geburtshilfe Frauenheilkd. 2019 Feb;79(2):148-159
pubmed: 30792545
Arch Gynecol Obstet. 2014 Jan;289(1):7-12
pubmed: 24220845
Chirurg. 1996 Apr;67(4):293-6
pubmed: 8646912
Geburtshilfe Frauenheilkd. 2019 Mar;79(3):268-280
pubmed: 30880825
Geburtshilfe Frauenheilkd. 2019 May;79(5):470-482
pubmed: 31148847
Geburtshilfe Frauenheilkd. 2018 Oct;78(10):927-948
pubmed: 30369626
Psychother Psychosom Med Psychol. 2019 Jul;69(7):293-300
pubmed: 30326537
Geburtshilfe Frauenheilkd. 2018 Nov;78(11):1089-1109
pubmed: 30581199
Breast Cancer Res Treat. 2012 Apr;132(3):1073-80
pubmed: 22205141
Geburtshilfe Frauenheilkd. 2016 Oct;76(10):1035-1049
pubmed: 27765958
J Clin Oncol. 2004 Sep 15;22(18):3685-93
pubmed: 15289491
Cancer. 2002 Feb 15;94(4):889-94
pubmed: 11920455
Breast. 2010 Apr;19(2):120-7
pubmed: 20117932
Geburtshilfe Frauenheilkd. 2019 Feb;79(2):160-176
pubmed: 30792546
Geburtshilfe Frauenheilkd. 2019 Mar;79(3):256-267
pubmed: 30880824
Geburtshilfe Frauenheilkd. 2018 Oct;78(10):949-971
pubmed: 30364388
Breast. 2015 Apr;24(2):118-23
pubmed: 25515645
Oncologist. 2017 Oct;22(10):1197-1211
pubmed: 28606972
Geburtshilfe Frauenheilkd. 2013 Nov;73(11):1135-1138
pubmed: 24771900
Geburtshilfe Frauenheilkd. 2019 Oct;79(10):1079-1089
pubmed: 31656318
Geburtshilfe Frauenheilkd. 2017 Feb;77(2):169-175
pubmed: 28331239
Pathologe. 2010 Sep;31(5):331-2
pubmed: 20703480
Eur J Surg Oncol. 2006 Feb;32(1):108-12
pubmed: 16303280
Z Evid Fortbild Qual Gesundhwes. 2015;109(6):459-65
pubmed: 26474651
Dtsch Med Wochenschr. 2017 May;142(9):e51-e60
pubmed: 28241373
Geburtshilfe Frauenheilkd. 2019 Oct;79(10):1090-1099
pubmed: 31656319

Auteurs

Michael P Lux (MP)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Breast and Gynecological Cancer Center, Women's Hospital St. Louise, and St. Josefs-Krankenhaus Salzkotten, St. Vincenz Hospital GmbH Paderborn, Paderborn, Germany.

Sonja Wasner (S)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Julia Meyer (J)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Lothar Häberle (L)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Carolin C Hack (CC)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Sebastian Jud (S)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Alexander Hein (A)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Marius Wunderle (M)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Julius Emons (J)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Paul Gass (P)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Peter A Fasching (PA)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Sainab Egloffstein (S)

Comprehensive Cancer Center Erlangen - European Metropolitan Region Nürnberg (CCC Erlangen-EMN), Erlangen, Germany.

Jessica Krebs (J)

Department of Psychosomatic and Psychotherapeutic, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Yesim Erim (Y)

Department of Psychosomatic and Psychotherapeutic, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Matthias W Beckmann (MW)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen - European Metropolitan Region Nürnberg (CCC Erlangen-EMN), Erlangen, Germany.

Christian R Loehberg (CR)

Department of Gynecology, Erlangen University Hospital, University Breast Center and University Gynecological Cancer Center for Franconia, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Classifications MeSH