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A breast diagnosis second opinion service from expert pathologists

Diagnosis by world renowned breast pathologist,
David J. Dabbs, MD.

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David J Dabbs, MD

“Breast pathology literature recommends a second opinion for breast biopsies, as they are critically important for determining the correct surgical and medical treatments for a patient with a breast lesion.”

BREAST SOS
a second opinion service, to verify, modify if needed, and help you better understand your diagnosis.

What is a Second Opinion Service?

A second opinion is a request to another health care professional by you, your breast care team or your health care plan to review medical records and lab test results.

  • The second opinion occurs after the initial pathology report is complete, but
  • Before having surgery, or
  • When planning treatments after surgery
  • It is performed remotely and doesn’t require a doctor’s visit
  • The second opinion may confirm your doctor’s diagnosis, revise the diagnosis, provide more details about the type and stage of breast disease, raise additional options and recommendations

Your physician is familiar with patient requests for a second opinion and this short delay before commencing treatment will have no significant impact on your treatment.

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Why a second opinion is recommended

  • Your pathologist is not a breast specialist
  • Your doctor tells you there is uncertainty about the type or extent of the breast cancer you have
  • You want your options explained by someone else
  • You have an uncommon diagnosis
  • You have questions about your diagnosis
  • Your health insurance plan requires a second opinion before having a particular treatment
  • Your doctor recommends that you seek a second opinion
  • You feel that all options have not been explored
  • When the initial pathology report is complete
  • Before having surgery
  • When planning treatments after surgery

Breast pathology has become increasingly nuanced and requires a level of expertise from trained and experienced specialists. Currently, only 10-20% of patients have access to specialists trained in breast pathology. Even trained breast pathologists may conflict in their diagnosis of the same case.

Inaccurate diagnosis leads to unnecessary clinical interventions which may have their own side-effects, increased anxiety for the patient and her family and increased costs. Patient Advocacy Groups, academic institutions, and expert physicians alike, advise of the necessity of second opinions to confirm diagnosis and provide as much information as possible for the patient.

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Why select PreludeDx’s BREAST SOS to provide your second opinion?

Dr. David DabbsPreludeDx was founded on the principles of Patient Focus, Quality First and Driving Innovation. Prelude has been active in research and development of novel breast focused tests for 15 years. During this time, we have had exposure to some of the world’s best breast pathologists, surgeons and radiation oncologists.

We believe every patient should have access to an expert second opinion. BREAST SOS was created to address this need and is led by world renowned breast pathologist, David J. Dabbs, MD. Dr. Dabbs has over 30 years of experience in direct patient care and clinical research at university-based pathology practices. He has educated hundreds of other pathologists globally through his previous academic appointments including most recently as Professor and Chief of Pathology at Magee-Women’s Hospital of UPMC, Pittsburgh, PA. He has led presentations at key international medical meetings and co-authored textbooks which have become the diagnostic standard in pathology, Breast Pathology and Diagnostic Immunohistochemistry (Elsevier, New York). Dr. Dabbs has advanced the field of breast pathology and the cancer community’s understanding of ductal carcinoma in situ (DCIS) and breast cancer by publishing over 200 papers in peer-reviewed medical journals.

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Services

BREAST SOS includes the following services across benign, precancerous or malignant conditions. After you complete a request form we will:

  • Reach you to discuss the process
  • Acquire your tissue block(s) from your biopsy or surgery. We will also gather the pathology reports provided to your physician.
  • Review the existing results, reports and diagnosis
  • Repeat testing if needed
  • Perform appropriate additional lab stains
  • Render a definitive diagnosis
    • Accurate staging
    • Confirmatory diagnosis
  • Perform DCISionRT to inform the decision for radiation therapy if the diagnosis is DCIS, if indicated.
  • Deliver the report via Fedex (or other methods requested by patient)
  • Discuss results of testing with you
  • Consult with your local pathologist and physician upon your request
  • Return slides or block via first class mail to the storage facility
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What does it cost?

  1. PreludeDx will charge $250 to your credit card for the second opinion service. The company will submit a claim to your insurer and attempt to collect. In the event Prelude collects, all or part of the credit card charge will be refunded
  2. Additional stains, if needed, will be billed to your insurance
  3. DCISionRT (if applicable) will be billed to your insurance and is subject to Prelude’s billing policies and practices
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Our Experts

Our team is composed of expert breast pathologists with greater than 75 years of combined experience and experience with tens of thousands of patient cases.

David J. DabbsMD – Chief of Pathology
Dr. Dabbs joins PreludeDx with over 30 years of experience in direct patient care and clinical research at university-based pathology practices. He has educated hundreds of other pathologists globally through his previous academic appointments as Professor and Chief of Pathology, presentations at key international medical meetings and co-authorship of textbooks that have become the diagnostic standard in pathology, Breast Pathology and Diagnostic Immunohistochemistry (Elsevier, New York). Dr. Dabbs has advanced the field of breast pathology and the cancer community’s understanding of ductal carcinoma in situ (DCIS) and breast cancer by publishing over 200 papers in peer-reviewed medical journals.
Jess Savala JrMD – Medical Director
Dr. Savala is a pathologist board certified in anatomic, hematopathology and clinical pathology. He currently serves as Medical Director of PreludeDx and is an expert in breast pathology with 20 years of experience, 10 of which have been breast focused. Dr. Savala’s previous experience includes Director of Molecular Pathology for Cynogen (wholly owned subsidiary of Abbott Laboratories), Laboratory/ Medical Director of MDxHealth, Laboratory/Medical Director and Director of Hematopathology at PLUS Diagnostics Inc., Director of Hematopathology for both the Physician Services and Analytical Services divisions of Genzyme Genetics, Laboratory/Medical Director of US LABS, Co-Medical Director and Scientific Director of Oncology of Specialty Laboratories, as well as several years of community pathology practice in California. Dr. Savala obtained his undergraduate degree from Loma Linda University with his medical degree from Loma Linda University School of Medicine. He completed his pathology residency at the Loma Linda University Medical Center, with additional fellowship training in hematopathology at Cedars-Sinai Medical Center (Los Angeles, CA)
F. Scott HeinemannMD – Senior Pathologist
Dr. Heinemann is a board certified pathologist with over 30 years of experience in anatomic and clinical pathology. He currently serves as Senior Pathologist for PreludeDx and is on staff at Hoag Medical Center as Medical Director of Breast Pathology in Newport Beach, CA. Dr. Heinemann is an expert in breast pathology and reads cases for renowned breast surgeon Dr. Mel Silverstein. Dr. Heinemann received his medical degree from University of Connecticut and trained at Yale University School of Medicine where he was Chief Resident. In addition, Dr. Heinemann trained as a Fellow in Surgical Pathology at Memorial Sloan-Kettering Cancer Center. He has a passion for research and published over 30 scientific articles. He completed his Anatomic Pathology Residency at Yale School of Medicine. He is currently the Medical Director of Breast Pathology at Hoag Medical Center. His Professional interests include: general surgical pathology, outpatient pathology services, breast pathology and molecular pathology. Most recent research activity includes study of the characterization of aggressive estrogen receptor positive (Luminal B) breast cancers to identify targeted therapies (2012-present).

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What is the role of a pathologist in determining your diagnosis and care?

Under the Microscope

When your breast was biopsied, the samples taken were studied under the microscope by a specialized doctor – a pathologist.

A Series of Tests

The pathologist will perform a series of tests on the biopsy and nearby tissues to create a “profile” of how the breast tissue looks and behaves.

A Diagnosis

The pathologist provides a diagnosis to the treating physician.

Treatment Recommendation

Without an accurate diagnosis, the treatment team may not select the best treatment for your specific condition.