Thyroid Cancer 101: Why Outside Second Opinions Matter.It can result in major therapeutic and prognostic modifications.

Thyroid Cancer 101: Why Outside Second Opinions Matter.It can result in major therapeutic and prognostic modifications.

Thyroid Cancer 101: Why Outside Second Opinions Matter.It can result in major therapeutic and prognostic modifications.

Thyroid Cancer 101: Why Outside Second Opinions Matter.It can result in major therapeutic and prognostic modifications.

Dr.Guttler’s comments on this important article to protect your health if you are told to have surgery for a suspicious thyroid nodule or cancer.

1.Clinicians relie on the pathology report to determine the treatment course for our thyroid cancer patients.

2. However not all pathologists are equal in giving us what we need to treat.

3. Leeds referral center looked at 66 cases and when there was a disagreement a third blinded set of eyes looked at the slides.

4.12/66 had a different diagnosis.

5. 2/66 had the diagnosis changed to benign!

6.8/66 had the prognosis downgraded to low risk.

7.4/66 had the diagnosis upgraded to more severe.

8. 5/66 had their management altered completely by a new pathologic diagnosis.

9. A second opinion of surgical pathology for thyroid tumours can result in major therapeutic and prognostic modifications.

10. All cases of suspected thyroid cancers should have second opinions for not only the pathology but also a complete review of the diagnosis and treatment plan by a thyroid cancer expert.

Call me at 310-393-8860, or Email to thyroid.manager@protonmail.com for details how to get my opinion before you have surgery. Surgery is most always elective and not an emergency. You have time to get opinions before you have the surgery. Also some patients who do this may not need surgery, or have the extent of surgery decreased. Also some small micro-papillary cancers are can be treated by Active Surveillance or Ethanol PEI or radiofrequency ablation RFA without surgery.

What is your hurry to have surgery? This is not breast cancer or other fast growing tumors. Today many previously called thyroid cancer are now found to have a benign tumor that is a look a like to papillary thyroid cancer. Non-invasive Follicular tumor with papillary like cytology NIFT-P is now benign and needs no long term treatment plan for cancer.

Surgical pathological second opinion in thyroid malignancy: impact on patients’ management and prognosis

Objectives

To evaluate the effect of inter-institutional surgical pathology review of thyroid cancer on patients’ treatment and prognosis.

Methods

All cases referred to the Institute of Pathology at Leeds for thyroid pathology review between January 2001 and March 2003 were included. The referring pathologists reports were compared to those produced in the MDT meeting by the expert pathologist. Whenever there was disagreement a third expert opinion was sought who was blinded for both diagnoses. Effects on management and prognosis were evaluated if there was disagreement.

Results

Of the 66 patients reviewed, 12 (18%) had a different pathological diagnosis (κ=0.33). Two had their diagnosis changed from malignant to benign and a further two from benign to malignant. Eight patients had their prognosis downgraded and four upgraded after histopathological review. Five patients had their management affected by the new pathological diagnosis.

Conclusion

A second opinion of surgical pathology for thyroid tumours can result in major therapeutic and prognostic modifications. All cases of suspected thyroid cancers should be reviewed in a multidisciplinary meeting supported by pathologist with experience in thyroid pathology.

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