What's the best way to ask for a second opinion on my mother's breast cancer?

Getting a second (or even a third) opinion is critical to identifying the right type of care, so don't let a prickly personality stand in your way.

The best strategy is to make your mother's oncologist feel respected and part of the process right from the start. Your goal should be to turn him into a partner in your mother's care, not an obstacle. Ask him, "If you were in my shoes and taking care of someone you love, what other doctors or treatment centers would you consult to make sure you're making the right decisions? And what are the questions you'd ask?" If he balks at all, try a little self-deprecating humor. "I know I'm being a little obsessive about all this," you might say, "but I'd just feel much better if I had more information and more perspectives to help me sort through the options."

If you already have an expert in mind for a second opinion, tell your mother's doctor whom you're thinking about seeing -- they may know of or have heard of each other.

If you ask your mother's oncologist to recommend someone for a second opinion, be sure to communicate any qualifications or criteria you have in mind. If your mother's oncologist is recommending against surgery, for example, you might want to talk to an oncologist who usually advocates surgery -- just to reassure yourself. Don't settle for a second opinion from a doctor in the same practice, though; it's best to find a doctor from an outside practice who specializes in the same field.

One caution: when it comes to referrals, don't feel you need to follow up on every suggestion from friends or family. ("My uncle Jim is a doctor; why don't you call him?") Sometimes referrals are very helpful, but other times the referring person may unintentionally lead you toward someone who isn't appropriate. This often happens because the well-intentioned friend or family member doesn't have all the specifics about the type of cancer your mother has or how far it has progressed. If you think the referral may be on target, do some follow-up investigation before you suggest to your mother that you seek the additional opinion. That way you don't raise false hopes or overload your mother with information that doesn't turn out to be relevant.

Whatever you do, seek second opinions right away, while all test results are current. If time passes, the second opinions may not match the first -- either because the cancer has progressed or improved in the meantime or because your mother's condition has changed in other ways.