CHI Memorial of Chattanooga, Tenn., has opened a Second Opinion Clinic to help women newly diagnosed with breast cancer better understand their diagnosis and treatment options and to address their questions and concerns. The clinic also assists women who did not receive a breast cancer diagnosis but whose images were abnormal.
CHI Memorial family nurse practitioner Casey Waddle, center, discusses breast imaging with a group conducting a second opinion review. At her left is Angela Reich, a women's health nurse practitioner.
The clinic is part of CHI Memorial's MaryEllen Locher Breast Center, a comprehensive breast center, as designated by the National Quality Measures for Breast Centers.
Dr. Betsy Washburn, surgical breast oncologist and medical director of the breast center, said that as a comprehensive breast center, the MaryEllen Locher facility always has offered second opinions. What is new is that it has organized the services under a clinic structure with a more patient-friendly process.
The clinic aims to assure women that they have an accurate diagnosis and the appropriate care plan, said Washburn. She said the clinic's goal is to make certain that all appropriate options have been addressed before a patient undergoes treatment.
A nurse navigator at the center guides each patient through the steps to obtain her medical records, including imaging and/or biopsy results and pathology reports for review by the center's breast care team. That team includes CHI Memorial breast surgeons, oncologists, a breast imaging specialist and pathologist.
The hospital and its breast center also have radiologists, reconstructive surgeons and other specialists who can provide their opinions during the review.
That team makes a diagnosis and recommendations for care; and a nurse practitioner reviews the recommendations with the patient in a face-to-face meeting.
The review team occasionally identifies mis–diagnoses, and it commonly recommends that surgical procedure plans be altered, said Angela Reich, a nurse practitioner on the second-opinion review team.
If the review team recommends additional imaging or biopsy, or if that team's consensus differs from the original opinion, the patient makes the decision on how to proceed. She may return to her original provider, change to providers at CHI Memorial or seek a third opinion.
A physician referral is not necessary to use the Second Opinion Clinic, and many insurance policies cover second opinion reviews, according to information from the breast center.