As a consultant in gynecologic pathology, I receive requests for second opinions from patients who have been diagnosed with endometrial hyperplasia. My opinion is based upon correlating the relevant clinical history with a review of the patient’s pathology slides and report. In my experience, there is a difference of opinion that leads to a change in treatment in about half of the cases. 75 percent of cases with changed diagnoses ...

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Patients are gradually becoming more aware of the value of second opinions on their pathology slides. When there is a significant change in the diagnosis, the decision to get a second opinion can be life altering and even life-saving. A recent example is the case of Rita Wilson, where the self-initiated second opinion of her breast biopsy resulted in a change in diagnosis from a non-invasive lesion ...

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A recent case that I saw in consultation at the patient’s request highlights the pervasive problem of overdiagnosis and overtreatment of endometrial hyperplasia. This 46-year-old woman was diagnosed with simple hyperplasia without atypia within an excised endometrial polyp, for which both her gynecologist and pathologist recommended hysterectomy. The basis for this recommendation was a perceived increased risk of endometrial cancer, either currently lurking within her uterus or to be developed ...

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Patients are becoming more and more adept at taking control of their own health care, and this often involves seeking a second opinion of their presumptive diagnosis. However, in far too many cases in which cancer or precancerous conditions are diagnosed, the consultation is at the level of another treating physician, without confirmation that the patient’s pathologic diagnosis is correct. In cases where clinical management decisions and prognosis hinge on ...

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