title: A prospective evaluation of the impact of second-opinion histopathology on diagnostic testing, cost and treatment in dogs and cats with cancer.
abstract: Second-opinion histopathology is a common practice in human medicine to avoid unnecessary procedures, costs and to optimize therapy. Histopathology review has been recommended in veterinary oncology as well. In this prospective evaluation of 52 tumours over a 1-year period, there was diagnostic agreement between first and second opinions in 52% of cases. Twenty-nine percent of cases had partial diagnostic disagreement, most often a change in grade, tumour subtype or margin status. Nineteen percent had complete diagnostic disagreement, including a change in cell of origin or a change from benign to malignant. Minor disagreements, which would not affect treatment or prognosis, were present in 21% of cases. Major disagreements, which would affect either treatment or prognosis, were present in 37% of cases. Costs of ideal staging and treatment recommendations were considerably different between first and second opinions.
authors: Department of Clinical Sciences, College of VeterinaryMedicine, Cornell University, Ithaca, NY, USA.|Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA.
authors: R C
authors: RC
authors: Regan
authors: Department of Clinical Sciences, College of VeterinaryMedicine, Cornell University, Ithaca, NY, USA.|Department of Oncology, Veterinary Medical Center of Central New York, Syracuse, NY, USA.
authors: K M
authors: KM
authors: Rassnick
authors: Department of Clinical Sciences, College of VeterinaryMedicine, Cornell University, Ithaca, NY, USA.|Department of Oncology MedVet Medical & Cancer Center for Pets, Columbus, OH, USA.
authors: E K
authors: EK
authors: Malone
authors: Department of Clinical Sciences, College of VeterinaryMedicine, Cornell University, Ithaca, NY, USA.
authors: S P
authors: SP
authors: McDonough
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000175:diagnosis / Q000191:economics / Q000473:pathology* / Q000628:therapy; D002415:Cats; D004283:Dog Diseases / Q000175:diagnosis / Q000191:economics / Q000473:pathology* / Q000628:therapy; D004285:Dogs; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000191:economics
keywords: oncology; pathology; second opinion; small animal; surgical pathology