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A Second Opinion is a Must for a Non-Specific Biopsy

Posted Apr 25 2010 7:16am

I don't think most people without and without medical training realize how many mistakes and wrong diagnoses are made on biopsies. It can be a biopsy of suspected cancer, a muscle biopsy or biopsy of an organ for questionable problems.

A woman called yesterday asking what I would suggest for someone who had been told that the biopsy of the lymph node in her neck showed "non-specific" cells and yet she was scheduled for a partial removal of her thyroid.

I was astounded. "No", I said, "she needs a second opinion and if necessary further sections should be cut on the tissue or a repeat biopsy should be done. Was a biopsy done of the thyroid and did she have chest and breast X-rays?"

I told my friend about the many muscle biopsies that I had reviewed, many from big teaching centers. Often the biopsy was unreadable or the diagnosis was wrong. The worst ones were those called muscular dystrophy when that was not the diagnosis. One case was a sweet little girl who had dermatomyositis, a treatable muscle disease. Fortunately, she had smart parents who asked me to see the child and together with her pediatrician, steriods were started and the little girl got well. The doctor, from a big medical center, refused to accept he had made an erroneous diagnosis  he had based on the reading of the biopsy. No pathologist can possibly know everything. That is why a second or even third opinion is crucial before a major surgery or treatment for cancer.  The slides can be sent or hand carried to another doctor or center and this must  be done.

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