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When Jane DeShaw was diagnosed with breast cancer, her mind was awhirl.
"Your mind is muddled because everything happens so quickly, while you're still trying to wrap your head around having cancer," she says.
Within days of a suspicious mammogram in 2013, she was scheduled for a stereotactic breast biopsy, but at the last minute, that procedure was aborted in favor of a wire-guided breast biopsy. The pathology report from that biopsy showed a breast cancer.
A week later, a sentinel lymph-node biopsy was performed, with all procedures handled by a local general surgeon, who had also treated her father for colon cancer.
"You see the surgeon, the oncologist, the radiation oncologist, you see so many people that you feel like you are getting a second opinion," she remembers. But experts say that it's best to go outside a local group for a second opinion, because physicians in the same practice likely share the same theories on treatment.
DeShaw suffered a painful complication of her biopsies: axillary web syndrome, which results in raised cords from the site of the breast and lymph node biopsies. It eventually cleared with physical therapy. Because her sentinel lymph nodes were clear, she did not undergo chemotherapy, but did have 33 rounds of radiation therapy.
Unfortunately, a follow-up mammogram the next year showed another suspicious area in the same breast, and DeShaw was faced with yet another round of decision-making. This time, she got up her courage to tell her doctor she'd like another opinion of her options.
"I'm the poster girl for not wanting to hurt anyone's feelings; here in the Midwest, we're brought up to be polite, sometimes too polite," she says. But to her relief, her doctor was not offended. "He said, 'Jane, that's fine,' " she recalled, and when she mentioned going to Madison, he told her he'd heard good things about the University of Wisconsin Breast Center.
So Jane and her husband Phil made the two-hour drive from their home in Dyersville, Iowa - home of the iconic "Field of Dreams” baseball movie - to the UW Carbone Cancer Center in Madison.
There she met with surgical oncologist Dr. Heather Neuman and they talked through her various choices.
Neuman says it's important for women to talk through all the steps and clarify what is most important to them. For some, it is conserving their breast tissue. For DeShaw, it was most important to her not to have to worry about cancer recurring.
"I was tired from everything that had happened and knew that I didn't want to live my life under the threat or worry that it would come back," she says.
She opted for a double mastectomy with reconstruction. Dr. Ahmed Afifi, a reconstructive surgeon, and Neuman, operated together during the 9½-hour procedure. Afifi is experienced in reconstructing breast tissue that had been made more delicate by previous radiation, a fact that made DeShaw even more certain she had made the right choice in coming to UW.
"There are some surgeons who won't even touch radiated tissue for a reconstruction, so I wanted to go where they were experts in the procedure," says DeShaw.
Neuman says she likes to involve the reconstructive surgeons at the first consultation, so patients can make decisions with their end goal in mind. Taking time to talk through each step is worth it, she says.
"A breast cancer diagnosis is not a medical emergency," Neuman says. "Yes, it has urgency, but I tell my patients that there's time to make a good decision. It's a decision that you're going to live with for the next 30 or 40 years.”
Even if the second opinion is the same as the first, Neuman believes there is a benefit to hearing it, especially since a breast cancer diagnosis carries with it so much stress and so much information.
"Sometimes just hearing information for a second time makes it clearer," Neuman says.
As for DeShaw, the results of the pathology report this time were negative, and she's very pleased with how her reconstruction turned out. She says her oncologist at home complimented how nice it looked and asked who did the surgery. She also went immediately to physical therapy and did not have the cord syndrome that followed her first biopsy surgeries.
"I feel I have excellent doctors at home, but if I could tell another woman what I learned, I would tell her not to be afraid to get a second opinion right away," she says. "It doesn't hurt to get all the information possible and discuss and review options with another medical expert so when all is said and done, there are no regrets. I am fortunate that I am in excellent hands both at UW-Madison and at home."