A second opinion, second chance
A patient scheduled a double mastectomy — but a last-minute second opinion at UF Health Jacksonville helped her avoid the procedure.
By Richard Jones
This was the experience of Diana Coffman after her gynecologist diagnosed her with fibrocystic breasts. Her doctor thought she might develop breast cancer, so to keep track of her numerous cysts, he prescribed an aggressive and painful treatment plan.
Every three months she had to go in for a mammogram. And each time she went, they recommended a biopsy.
“When I would leave the hospital after a biopsy, I felt like I got hit by a truck,” Coffmann said. “I came home looking like a punching bag. And it seemed like by the time I healed up from one biopsy, it was time to go in and have another.”
At the same time, she was being worn down by constant mental anguish — the fear that one day the tests would show she had cancer. Finally, sick and exhausted by the whole process, she decided to get rid of the problem forever by having her breasts removed.
Without her family’s knowledge, Coffmann made an appointment with a surgeon.
“After a physical examination and review of my tests, he told me I was absolutely a candidate to have both breasts removed,” she said. “A reconstructive surgeon agreed with the plan and my insurance company approved it for payment.” A double mastectomy and reconstructive surgery were scheduled for the next week.
“It was tough,” she said. “But I came home and told my family. They panicked and tried to talk me out of it, but I’d had enough. I just wanted the pain and fear to go away.”
Fortunately, Coffmann’s husband wouldn’t give up. He knew she was desperate but convinced her to see a doctor he knew at UF Health Jacksonville, Shahla Masood, M.D., for a second opinion.
Reluctantly, she agreed.
Several days before her surgery, Coffmann gathered up all of her test results and took them to Masood. After reviewing the records, Masood ordered a genetic test called the breast cancer susceptibility gene, or BRCA test, to check for mutations that would show if she were at high risk for cancer. The test came back negative, indicating that Coffmann was free of any cancer-causing genes.
“That’s when Dr. Masood said the words that changed my life,” she said. “She told me there was no reason to take my breasts off. She just didn’t see a reason.”
In addition to canceling the mastectomy, Masood prescribed a much less radical treatment plan consisting of annual mammograms.
“What a relief,” Coffmann said. “No surgery, no more biopsies. I couldn’t believe it.”
In Coffmann’s case, there was no scientifically sound reason for such a drastic approach as removing both breasts, said Masood, chair of the department of pathology and laboratory medicine at the College of Medicine – Jacksonville, medical director of the Breast Health Center at UF Health Jacksonville and an internationally recognized expert in the fields of cancer diagnosis and prognosis, breast health and pathology.
“Removal of a breast should be the last option,” she said.
“Sometimes the patient gets paralyzed with the fear of cancer. They want the breast off.”
Coffmann is now under the care of Masood. No more abnormalities have been found in her breasts and she has had no further biopsies.
“Thank goodness my husband convinced me to get a second opinion,” she said. “Dr. Masood’s diagnosis saved my breasts and took away all the pain and anxiety. There’s not a day that goes by that I don’t think of her and thank her for giving me my life back.”