HER MAGAZINE

UIHC surgeon faced her own breast cancer diagnosis

Dr. Carol Scott-Conner has an informed and personal perspective on breast cancer, both as a surgeon and a cancer survivo
Dr. Carol Scott-Conner has an informed and personal perspective on breast cancer, both as a surgeon and a cancer survivor herself. (Photo courtesy UIHC)

For years, Dr. Carol Scott-Conner performed breast cancer surgeries. And then one day, she was the breast cancer patient.

It was 2013 when the senior breast cancer surgeon at the University of Iowa College of Medicine was diagnosed.

“Like most women who get breast cancer, I had no family history or risk factors,” she said. “I went for a routine annual mammogram, and they found something. It was caught early, and I’ve done well. My patients taught me how to be a breast-cancer patient.”

Now retired with a professor emeritus appointment, Scott-Conner grew up on the East Coast, in New Jersey and Maryland. Her father was a physicist who worked for the government at the Aberdeen Proving Ground in Maryland.

“My parents encouraged me to dream big. At a time when many doors were closed to women, they helped me find my way to MIT — which had accepted women since it was founded — and supported my desire to go to medical school,” she said.

The Massachusetts Institute of Technology proved challenging for the electrical engineering major who was interested in neurosciences.

“I struggled academically,” she said. “I graduated, but my grades reflected my academic struggles.”

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At MIT, she married classmate Christopher Scott. Four years later, he suffered a stroke and died a week later. That harrowing experience pushed her to become a surgeon.

“He was hospitalized at the Massachusetts General Hospital, under the care of one of the premier stroke teams, but they had no answers to my questions,” she said. “When I asked, ‘Why did this happen? Is he going to recover?’ the answer was always, ‘We don’t know,’ and they had no treatment.”

In medical school at New York University, she “fell in love with surgery partly because I didn’t want to have to tell patients there was nothing I could do. I also fell in love again and married Harry Conner, a classmate, and my husband of 47 years.”

BUILDING A CAREER

She decided on an academic career and started at the Marshall University School of Medicine in West Virginia. But “in order to advance up the academic ladder, you generally have to move.”

Her next stop was the University of Mississippi, paired with night school to get her master’s degree in business administration. The University of Iowa came calling in 1995, offering her the opportunity to lead the College of Medicine’s Department of Surgery. It’s a job she held until she retired in 2015.

Being a woman, she said, steered her toward focusing on breast cancer treatment.

“A lot of women want to see a female physician,” she said. “Simultaneously, breast cancer treatment and surgical oncology, in general, became so specialized that it was appropriate to concentrate in just that one area.”

Scott-Conner thrived as a surgeon.

“I felt like, although there was a discrete set of skills that I could learn, the discipline would reward and indeed require years of study,” she said.

HER DIAGNOSIS

Then came her own breast cancer diagnosis.

“I was lucky that I had that routine annual mammogram,” she said. “I could have waited two years — a lot of people were advocating for that.

“But my cancer, even though it was found early, showed signs of trying to spread to the lymph nodes. Another year and it would have definitely been more advanced. I would have needed more aggressive treatment and my chance of cure would have been less.”

When it comes to treating breast cancer, early detection is the best weapon, she said.

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“But as treatment becomes more and more effective, it may become less critical to catch the disease early,” she added. “If we had a magic pill that would cure your cancer, it wouldn’t matter so much that it was caught small.”

We aren’t there yet, though.

“I believe women should start getting annual mammograms at age 40 and continue until they are quite elderly,” Scott-Conner said. “Most national organizations agree that this approach saves the most lives.

“The reason that we argue about whether or not every two years would be better, or that starting at age 50 might be better, is that many women will have findings on mammography that are not cancer. These are called false positives, and they cause unnecessary anxiety and even pain and suffering due to unneeded biopsies.”

The argument against annual mammography starting at age 40 “is primarily based on resource utilization, not what is best for individual women,” the surgeon said.

“Screening protocols for high-risk women are different and generally more aggressive,” she said, “I should add — men get breast cancer, too. Their treatment is patterned after women, and they, too, are benefitting from advances in treatment. We don’t routinely get mammograms on men, but if a man finds a lump in his breast, he should see his doctor.”

ADVANCES IN TREATMENT

There is good news in the fight against the disease.

“We now have drugs that really seem to work,” Scott-Conner said. “For certain kinds of breast cancer, we offer the woman up-front chemotherapy. That is chemotherapy before surgery, rather than the other way around.

“Sometimes when we do the surgery, we find that the chemotherapy has completely killed the cancer — a complete pathological response.”

As for breast reconstructive surgery, “the best results come when a cancer surgeon and a plastic surgeon work together,” Scott-Conner said. “If the cancer is small enough, we can spare the ‘skin envelope’ and sometimes the nipple-areolar complex, so that the plastic surgeon can create a very real looking and feeling breast.”

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Sometimes a woman’s non-cancerous breast can benefit from surgery, to ensure both sides match, she added.

“Virtually any woman facing breast cancer surgery should know that there are options,” she said. “A big message that I would like to get out there to women who have just found out they have breast cancer — take a deep breath and see what your options are. A second opinion may be a great idea to help you identify the best pathway for you.”

ON TO WRITING

With her professor emeritus status, Scott-Conner teaches first-year medical students and is co-teaching a non-credit course to retirees this fall.

“Our course is called ‘Creative Writing and Healing: Writing the Stories that Stay with You.’ It will allow me to share my interest in narrative medicine with a wider audience,” she said.

In addition, the lifelong learner is enrolled as a graduate student in a creative writing program.

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