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Susan Seeks Out Second Opinion After Doctor Recommends Breast Cancer Procedure That Would Be Considered a Success if She Lived 5 More Years

Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area.

Susan Seeks Out Second Opinion After Doctor Recommends Breast Cancer Procedure That Would Be Considered a Success if She Lived 5 More Years

Susan Garrahan didn’t feel she and her oncologist were on the same page when it came to his plan for treating her breast cancer.

The oncologist, to whom she had been referred by her insurance company, recommended a lumpectomy on her left breast followed by chemotherapy and radiation.

She wasn’t comfortable when he rebuffed her concerns about radiation, but she was most alarmed after learning that he would consider her treatment a “success,” if she lived for another five years. Then 48, Susan wanted to beat the cancer, retire from her job at Jet Propulsion Laboratory in 15 or 20 years and enjoy a long life in the company of her husband and family.

So she went in search of a second opinion, even though her insurance company did not want to pay for one. Her hunt for a fresh point of view led her to Ketan Patel, MD, and Maria Nelson, MD, associate and assistant professors of clinical surgery at the Keck School of Medicine of USC.

“I felt like they understood my questions and concerns about the risks, and I felt like they answered my questions honestly,” Susan says.

Nelson and Patel are part of a team of breast specialists at USC Verdugo Hills Hospital, who offer patients a unique approach to treating breast cancer by coordinating care at every step and collaborating to develop a comprehensive, personalized treatment plan that begins with understanding their patients’ expectations for their treatment.

“We spend time with them, learning what they expect and telling them about all of their options and the pros and cons of each,” Patel explains.

Nelson and Patel believe that working together improves outcomes for their patients. They always know what the other is planning, so there are no surprises for them or for their patients. They also perform the broadest possible range of surgical options, including procedures not offered everywhere such as DIEP flap reconstructions, in which fat, skin, and blood vessels from the lower belly are used to rebuild the breast.

Susan changed her insurance to a plan that would allow her to receive her treatment at USC Verdugo Hills Hospital. And while it was their willingness to work with her rather than dictate to her that made her take that step, she is glad for another reason.

After reviewing Susan’s records, Nelson performed additional tests that revealed precancerous tumors in her right breast and uncovered a rare genetic mutation that put Susan at high risk for developing soft tissue cancer.

“It’s not uncommon for a patient’s workup to be inadequate,” Nelson notes. “I find that with our multidisciplinary team approach, we are able to be more thorough and help ensure nothing is missed.”

Armed with better information, Susan chose to have a nipple-sparing double mastectomy to minimize the chance of recurrence and spare her from radiation. Nelson and Patel operated on her in tandem, performing the double mastectomy and the first phase of her reconstruction in one day.

But she’s grateful for more than just the care she received. “Dr. Patel and Dr. Nelson saved me from a terrible outcome,” Susan says. “I could have a large visible scar and radiation damage, and I also know that I would have gotten cancer in my right breast and would have gone through everything all over again.”

A little more than a year after her initial surgery, Susan has only one physical reminder of her breast cancer: a pencil thin scar on each now-healthy breast. And though she is also still taking tamoxifen, she says that her best medicine is Skippy, a dog she rescued and who now accompanies her on daily walks — another measure she is taking to stay healthy for the long run. That’s just another example of The Keck Effect.

by Hope Hamashige