Advice about Pathology slides and biopsies - Cancer: Skin Message Board

Oleander53 · 03-11-2009, 12:36 PM

I wanted to share a problem I have been having in hopes that others will not have this happen. My 2nd Biopsy done by a Dermatologist was read by himself. He trusts his own reading and did not send it out to Pathology. My first Biopsy done by a gyn was sent to the local hospital for reading. The Dermatologist re read the first one and read his own. I hope this makes sense.

Well I went to my Oncologist Gynecologist and did not like him. He seemed overly concerned about the 2nd biopsy being read by the Derm and not sent out for a Pathology read. Feels like it causes legal problems for him.???? I just did not connect with this guy.

MD Anderson has also now told me he should have sent them out for a formal Path reading....

I asked them how we as patients should know about these things? I am pretty up on medical issues.....had no idea this would cause me any future problem. All of my slides are being re read at this time.

So my advice to any of you getting a biospy done to make sure even if the Doctor is going to read his slides himself make sure that he send the specimen out to pathology for a formal reading. It is like you need a medical degree anymore...... I am very frustrated.

Did anyone catch Oprah yesterday? I rarely watch TV and never Oprah but it was a great show about medical errors on the rise and how to protect yourself. It talked alot about getting 2nd and 3rd opinions and being your own advocate. Very very good show. That Dr Oz was on there and did most of the talking. There was a case where someone's cancer slides got mixed up......a real mess but a true story............ make sure to ask questions.

Oleander
Bowen's disease 1/09
Squamous Cell carcinoma 1/09
Positive Margins 1/09
Hashimoto's 06
Insulin resistance 08

Chele60 · 03-12-2009, 01:54 PM

I'm really sorry this has happened to you. I think I would be a little suspicious of a dermatologist reading his own biopsy. After all, his speciality is the skin, sure, but a pathologist's speciality is, well, pathology and disease. To me, there is a reason why the two specialities exist. But I can see where people get confused - doctors exercise so much control over our lives, it's just incredible! We really do have to be our own advocates!

Oleander53 · 03-12-2009, 02:50 PM

It has all been very strange..... I understand how this Derm feels.....he is a Board certified Derm Pathologist and he told me straight up he only trusts his own readings and will send out for a 2nd opinion if necessary. He did not have any problem with his slides being sent to MD Anderson.....he seems very confident and frankly I liked him very much. Seemed to know more than the others I have seen......

He told me there was a 4% error in Path readings especially with Squamous cell because Melanoma and squamous can look similar......He wanted to make sure it was NOT a melanoma that had been misread. I really appreciated his honesty and concern..

But everyone else had a problem that he read his own slides... A BIG problem....So I will find out how his slides compared to MD Anderson's read.....We will see if it was really a problem or not.

But live and learn. Thanks!!! Oleander

teapotlady · 03-17-2009, 06:56 AM

I had heard quite a few horror stories about path reports for pap smears being read wrong. The longer they work the less accurate they become. Maybe start paying less attention? On the other hand Oprah just wanted a good show so she gets the worse cases to highlight. I don't think it is the majority like they sometimes make you think. It is a few tragic cases and make the news. But, we do have to be our own advocate. They see lots of patients and we have to be the ones on top of our health.
I hope your new slides come back OK.

Oleander53 · 03-17-2009, 07:54 AM

Teapotlady,

I saw the SAME SHOW. I really like Dr Oz.....I hope he does not get too Hollywood. My Endocrinologist loves him. I am a pretty difficult patient due to my background and I ask alot of questions. In California where I am from the Doctors expect it. Here in the South they are not used to it.

MD Anderson has my slides and has read them. They know the situation with who read what and they say it "should not have been done like that" but are okay with it. Frankly I trusted the Dermatologist more than anyone so far. He had a good head on his shoulders and knew a lot about what is wrong with me. More than anyone else so far. Maybe legally he should have sent it out for a 2nd opinion but he said he "only trusts his own readings". Probably for good reasons.

As I wait for my appt on 4/3. Worrying my SCC is spreading.

Hope you are doing okay. Oleander