Regular Breast Self-Exams Uncovered Cancer

On a scale of 1 to 10 for cancer care, Jean Wynn gives The University of Kansas Cancer Center a 12.

Jean, who was born and raised in Missouri, is a lifelong University of Missouri Tiger fan. Growing up on “that side” of State Line, Jean never imagined she would rave about The University of Kansas Health System. Of course, she also never imagined she’d be diagnosed with breast cancer.

Jean and her husband, Ray, were cheering for another Missouri sports team to win the 2015 World Series when they received the dreaded phone call. The small bump Jean had felt during a self-exam was breast cancer. Three trusted friends who had been through similar cancer experiences all recommended the same 2 physicians: medical oncologist Richard McKittrick, MD, and breast surgical oncologist Jamie Wagner, DO, both at The University of Kansas Cancer Center.

Educational approach to breast cancer treatment

When Jean met with Dr. McKittrick, she understood why her friends spoke so highly of him. “His focus on research and data made me feel good. He was thorough. Plus, he had a great bedside manner,” says Jean.

Dr. McKittrick believes it’s important to explain the diagnosis and treatment options clearly. “If a patient is hearing about cancer for the first time, it’s a lot to take in. I want to help them understand what’s going on and what to expect, so it’s a little less scary,” Dr. McKittrick says.

Next, Jean explored her surgical possibilities with Dr. Wagner. “I’m an educator. That’s a big part of my job,” says Dr. Wagner. “I educate breast cancer patients about mastectomy and the side effects. I educate them about reconstruction surgery. When it’s possible, we offer choices.”

Deciding on the right treatment plan

Jean’s cancer team performed additional testing to complete her cancer workup so that she would have the necessary information to make an educated decision. Her estrogen-receptor-positive tumor was small on initial imaging, but additional imaging identified much more disease in her breast. Drs. McKittrick and Wagner encouraged Jean to make a decision. After careful consideration, she agreed to have a single mastectomy, with evaluation of 6 lymph nodes for metastasis.

Many factors were in Jean’s favor. Thanks to regular self-exams and mammography, her cancer was caught at an early stage. After surgery, Jean’s margins came back clear. Even better, based on the type and size of tumor with no lymph node involvement, she did not require chemotherapy or radiation.

Dr. McKittrick prescribed a 5-year regimen of Tamoxifen, a daily pill to block the effects of estrogen-on-estrogen receptors. “I tell patients it’s like preventing crab grass in the spring,” he says. “You know you’ve had crab grass before, so it might be a good idea to put this treatment down in hopes that the crab grass doesn’t come back again.”

More decisions after breast cancer treatment

The hardest part of Jean’s cancer journey was over, but she still had one more choice to make. Would she undergo breast reconstruction surgery?

Some women who have mastectomies are candidates for reconstruction. Some are not. According to Dr. Wagner, “Jean was a candidate, but she made an educated decision not to have the surgery. I’m a supporter of reconstruction, but I also support doing what’s right for you.”

Dr. McKittrick agrees: “I can sit here in my office and make a recommendation, but the patient has to consider themselves, their families, their jobs, their support system, their finances,” he says. “They have to sort everything out and weigh all the risks and benefits.”

Physicians at The University of Kansas Cancer Center believe patients should have a say in their treatment.

“I never felt pressured to pursue reconstruction,” Jean says. “They wanted me to do what I was comfortable with.”

Jean was considering going back later for reconstruction surgery – but then her life became even more complicated.

Another cancer diagnosis

One year after Jean received the results of her breast biopsy, her husband, Ray, was diagnosed with throat cancer. “I put my cosmetic issue on the back burner to focus on taking care of Ray the way he took care of me,” she says.

Unfortunately, Jean had her work cut out for her. She discovered firsthand that cancer treatment is not the same at all cancer centers. Throughout Ray’s experience at another healthcare facility, Jean felt she had to request the high-quality care that seemed to come naturally at The University of Kansas Cancer Center.

“At the cancer center, the doctors and staff looked me in the eyes and really talked to me. I was not just another patient,” she says. Jean credits Brooke Miller, a clinical nurse coordinator, with making her feel at ease and in control.

Dr. Wagner explained why patient satisfaction is high at the cancer center. “The overarching theme here is compassionate care. I encourage all teams within the division of breast surgery to demonstrate compassion for our patients and patients have commented on this. I’m really proud of them.”

Team spirit

Today, Jean, 57, has a promising prognosis. She is tolerating her therapy well, with no sign of cancer. Ray is also on the mend from his cancer treatment. As a retired captain and 32-year veteran of the Kansas City Missouri Fire Department, it means a lot when he says, “Jean is the toughest person I know.”

“I am able to look back on my experience with breast cancer in a positive light,” Jean says. “Not just because the surgery and treatment were successful, but because the people were so caring. I was fortunate to have that team behind me.”

Speaking of teams, Jean and Ray admit they wore Mizzou shirts and hats to almost every appointment at the cancer center. “All in good fun, of course,” Jean says with a laugh. Dr. McKittrick, a Kansas State University alumnus, said he didn’t mind at all, “I love getting to know my patients’ favorite schools and sports teams. The personal interaction makes it all worthwhile.”