Scientists at the University of Michigan in Ann Arbor assessed 149 patients who came to its cancer center after receiving a treatment plan from a doctor elsewhere. A growing number of cancer centers coordinate care using a team, or "tumor board," including surgeons, oncologists, radiologists, pathologists, and nurses.

In several cases the team found that the original doctor failed to follow national treatment guidelines and proposed overly aggressive surgery. For example, five patients advised to undergo a mastectomy could instead safely get a breast-conserving lumpectomy. And 19 could have just one lymph node removed, at least initially, rather than several nodes as originally recommended.

The second opinions also disclosed problems missed by the first physician. In 43 women, radiologists spotted signs of tumors that required additional biopsies or imaging tests. In addition, the team found that two women who were originally told to undergo a lumpectomy could not tolerate the follow-up radiation, so a mastectomy was recommended instead. Overall, the second opinions produced treatment changes for 77 of the 149 women.

The study did not look at whether the second opinions improved the treatment outcomes. However, our medical consultants advise breast-cancer patients to seek a team review to help ensure that they know all the treatment options and that their care follows the latest guidelines. Such teams are becoming standard at teaching hospitals and large medical centers.

In addition, try to choose a surgeon who frequently performs breast-cancer operations and a hospital that specializes in cancer care.