Most patients that come to me with a breast problem are comfortable with thediagnostic and treatment plan they receive. However, some patients and/or family members request a second opinion. A second opinion is when a patient sees another doctor in consultation for the same condition.
SECOND OPINIONS MAY BE OBTAINED FOR SEVERAL REASONS
Is this really cancer? Or, are you sure this isn’t cancer? If this is the reason for the second opinion, biopsied tissue may be sent to another pathologist to be looked at under the microscope.
Are you sure my breast pain isn’t due to cancer? Do I really need a biopsy? Are you sure the mammograms okay? In these situations, the patient can be examined by another doctor or their images can be reviewed by another radiologist.
Here, the patient’s entire medical record including pathology slides and radiology images are be reviewed by a surgeon, medical oncologist, and/or radiation oncologist who then give their opinion on how to proceed.
Sometimes there is more than one good treatment plan in which case the patient is given choices. Keep in mind that equally good treatment plans can be vastly different. A good example of this are approaches to breast reconstruction.
The treatment plan seems to be what most patients want a second opinion about.
Patients may seek a second opinion in order to find a doctor that they’re more comfortable with or who specializes in their particular disease or who cared for someone they know.
Dr. Miltenburg’s patients are her patients for life. Not all patients want or need long-term follow-up. However, patientswho have received treatment for breast cancer, those at high risk for developing cancerand average risk women who want close follow up come back to the office on a regular basis. BHIH is committed to keeping in touch with their patients, dealing with problems that may arise and keeping patientsapprised of advances in breast health.
Patients seen at the Breast Health Institute of Houston are given the opportunity to obtain a second opinion by having their case presented at a multidisciplinary breast tumor conference. Patient are not present at tumor conference. Rather, their case is presented to members of the breast tumor board consisting of radiologists, pathologists, breast surgeons and plastic surgeons, medical oncologists and radiation oncologists from all over the city of Houston. In addition, the conference is attended by nurses, genetic counselors, physical therapist, social workers and administrators.
Our breast tumor conference is HIPPA compliant (Health Insurance Portability and Accountability Act). Patient names and identifying features are blocked from the conference attendees except for the physicians who are presenting the cases.
We review each patient’s breast images (mammogram, ultrasound, MRI) and we look at their pathology slides. Patients are staged according to the latest edition of the AJCC Manual (American Joint Committee on Cancer) and we follow the current NCCN guidelines (National Comprehensive Cancer Network).There is usually a lively academic discussion that can last anywhere from 10 to 45 minutes. We discuss the latest research and technology. In addition, physicians draw on their own experience. Individualized treatment recommendations, options and alternatives are developed for each patient.
The patient follows-up with mein the office after tumor conference and we discuss what happened at the meeting, review the recommendations and then formulate a plan.
This way, patients receive second opinions from multiple doctor experts without ever having to pick up their pathology slides, X-rays, reports or make an appointment.
Dr. Darlene Miltenburg is a great Doctor. She is very professional and knowledgeable. She has been God sent as she cared for my wife. She is also one of the Leaders in her field. She takes the time with her patients. I would highly recommend her, if you want a Doctor who care about patients.
I would recommend Dr. Miltenburg to anyone. So pleased with my breast surgery? Honestly, I did not know I had had surgery that she performed. I felt she cared about my first visit. Awesome doctor