louaci 发表于 2024-12-15 13:07 你可以查下surgical path有谁，private practice pathologist不见得比academic pathologist 差的 Google Sutter health pathology, 上面有22个pathologist,你看下履历。
看到楼里这么多人说不会，我要来贴一下一篇MD Anderson医生的文章。我把结果拷贝在这里。所以无论怎么样，最好是找一家大癌症中心寻求2nd opinion。 https://ascopubs.org/doi/abs/10.1200/JOP.2013.001204 A total of 2,718 patient cases were reviewed during September 2011. There was agreement between the original pathologist and our departmental subspecialty pathologist in 75% of cases. In 25% of cases, there was a discrepancy between the original pathology report and the subspecialty final pathology report; 509 changes in diagnosis were minor discrepancies (18.7%), and in 6.2% of patients (169 reports), the change in diagnosis represented a major discrepancy that potentially affected patient care.
Google Sutter health pathology, 上面有22个pathologist,你看下履历。
嗯嗯 去看斯坦福的医生，second opinion他们会看pathology报告。 但是我现在就担心术后sutter lab观察癌细胞这些会不会不够精确 导致pathology病理报告不精确……
求问下在哪里看surgical path呀？我目前在app里只看到手术的信息，别都没有。看不到送到哪里去了😪
大病理么？我不知道美国情况，在国内咨询过，手术中的快速病理可能有误差，但也不大。术后的石蜡大病理很准。
所以你担心的是取样问题？是刚好特别癌变部分没切下来？
亲 病理切片有有效期吗？等sutter看完，到时候斯坦福还可以去request ？就是说切片可以transit到斯坦福lab重新看？ 第一步是不是去找个斯坦福医生？然后麻烦她去request呀？（当然是等sutter结束病理报告后才行）。
可以的，一般医院还会留有一些sample，足够在做一次病理，你可以去别的地方寻求2nd opinion，然后医院之间会把你剩下的sample寄过去一些再做一次病理。
https://www.sutterhealth.org/smcs/doctor-search/results?specialty=Pathology&location=cleared&zip=&lat=&lng=&medical-group=sutter-medical-center-sacramento&health-plan=&health-plan-product=&newPatients=true&accepting-new=open
嗯嗯 国内术中就有快速病理。但是美国这边没有术中的。只有术后的一个病理。术后送去lab去研究出报告。 我担心切完后在术后送到lab里去分析的时候 会不会有些lab有不精确的情况，比如几mm？或者有几个几mm？或者各个不同恶性的ca的性质有各种不同的指标等等。我不懂细节，但是医生说后续的治疗都根据病理结果才能确定。所以就担心病理结果在sutter测会不会不够精确…………
https://ascopubs.org/doi/abs/10.1200/JOP.2013.001204
A total of 2,718 patient cases were reviewed during September 2011. There was agreement between the original pathologist and our departmental subspecialty pathologist in 75% of cases. In 25% of cases, there was a discrepancy between the original pathology report and the subspecialty final pathology report; 509 changes in diagnosis were minor discrepancies (18.7%), and in 6.2% of patients (169 reports), the change in diagnosis represented a major discrepancy that potentially affected patient care.
如果不放心，至少去看second opinion
楼主不放心的话就找second opinion，但Stanford本身教学医院，你当初真找他们做手术，说不准遇到的还是实习医生。Stanford这类教学医院，优势是在处理疑难杂症，提供clinical trail等等方面，并不是说常规procedure比别的地方强。
我理解你刚生病不久，心里没底，但乳腺癌是非常常见的病，各种procedure成熟得很，预后很好，找second opinion是必要的，但不用太疑神疑鬼，正规医院问题都没啥问题。
私你了