Second opinion before breast cancer surgery

Usually by a week or two, which is within the window where timing makes no measurable difference to outcome. Ask your first team to hold a provisional date while you arrange it, so you do not go to the back of the queue if you decide to stay.

Request them in writing from the hospital's pathology department, usually through your consultant's secretary. They are released to you or to the receiving hospital. Allow several days, and ask for imaging on a disc at the same time.

It depends on the question. For the operation itself, a breast surgeon at a centre with a tumour board. For reconstruction options, a reconstructive surgeon. For whether chemotherapy is needed, a medical oncologist. Be clear which question you are asking.

Go back to the first team with it rather than simply switching. Ask each to respond to the other's reasoning. Often the difference turns out to be about a trade-off you can weigh yourself, such as cosmetic result against a second operation.

Often a consultation fee, and sometimes a charge for re-reporting slides. Ask what the cost will be in advance, and ask whether your scheme or insurance covers it. Many centres offer a no-charge review of an outside report.

Yes, at any point. It is most useful before an irreversible step such as surgery. If you are partway through chemotherapy, a second view on the surgical plan is still entirely reasonable and does not require stopping anything.

It can be useful for reviewing reports and images, particularly if travelling is hard. It cannot include an examination, which matters for judging whether the breast can be kept. Treat it as a supplement rather than a substitute.

Two experienced views are usually enough. Beyond that you tend to collect confusion and delay rather than clarity. If you find yourself seeking a fourth, the difficulty is often about the decision itself, and a counsellor may help more than another surgeon.