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OBJECTIVE To examine the association between whether physicians discuss the possibility of seeking a second opinion (SO) with patients and the patients' decision to seek an SO. We also investigated the impact of seeking such an opinion on patients' trust in physicians. METHODS Newly diagnosed breast cancer patients were surveyed postoperatively with a mail survey. A patient survey is carried out annually to evaluate the breast cancer centers in North Rhine-Westphalia, Germany. In 2016, survey data from 4517 patients in 87 hospitals were analyzed. RESULTS Physicians were more likely to inform patients under the age of 75 years with higher education levels about the possibility of seeking an SO. Our results indicate that requesting another opinion is associated with less trust in the physician. CONCLUSION Our results indicate that physicians may selectively inform only a subset of patients about the possibility of seeking an SO. Patients who were informed about such a possibility are more likely to do so. PRACTICE IMPLICATIONS Physicians may need to be careful to avoid inequalities based on the age and education of patients regarding giving information about the possibility of an SO. Moreover, breast cancer centers could provide material to patients regarding seeking an SO.