A routine mammogram led to a breast cancer diagnosis—and a genetic discovery that may have saved her life.
In March 2024, Leslie Coffin received a call from her former doctor’s office in Des Moines about the results of her recent screening mammogram and to request she come in for a follow-up ultrasound. The Marion resident was fairly new to the area, was starting a new job and hadn’t yet established care with a local provider.
“I have dense breast tissue, so I’ve been called back for an ultrasound before. I wasn’t too worried about it,” said Coffin. “My sister told me about St. Luke’s Breast and Bone Health, and once I had my benefits set up, I scheduled the appointment in April.”
From Routine Screening to Cancer Diagnosis and Treatment
Coffin went into her ultrasound at UnityPoint Health – St. Luke’s Breast and Bone Health expecting it to be routine. But this time, it was different.
“I remember the doctor saying he thought there may be cancer in there, and at that point, I just blacked out,” shared Coffin. “He was still talking, but I don’t remember anything he said.
“I’m a numbers person,” she continued, “So I asked, ‘If you had to give a percentage, how likely is it that this is cancer.’ He said 99%.”
Coffin was immediately scheduled for a biopsy, which confirmed the doctor’s suspicions. She was diagnosed with stage 1A breast cancer at just 45 years old. Coffin received the news from her care coordinator, Mona Cook, BSN, RN, CBCN, with the Nassif Community Cancer Center.
“Mona held my hand and walked me through what the diagnosis meant, and what the next steps would be,” Coffin said. “She booked me an appointment with my surgeon right away.”
Alexandra Bors, MD, FACS, general surgeon with Physicians’ Clinic of Iowa, performed the procedure – a lumpectomy, or removal of the cancerous tumor – in late May. This was followed by five weeks of radiation therapy at UnityPoint Health – St. Luke’s Nassif Radiation Center.
“Everyone who cared for me was amazing,” said Coffin. “Dr. Bors was so patient and kind, and the team at the radiation center always welcomed me with a smile and cheered me up even when I was exhausted from treatment.”
Genetic Testing Reveals a Rare Condition
Because breast cancer can have a genetic component to it, Coffin also scheduled an appointment with Genetics Nurse Practitioner Melissa Janssen, MSN, ARNP, FNP-BC, in the Community Cancer Center’s Genetics and Cancer Risk Assessment Clinic. Mutations of the BRCA genes are what most people commonly associate with breast cancer. Thankfully, results were negative for BRCA mutation, however, the results were positive for a different genetic mutation called SDHB deletion. In rare instances, SDHB deletion can lead to neuroendocrine tumors called paragangliomas.
“Melissa explained to us the SDHB deletion mutation, but I was in the middle of my breast cancer journey at the time, so it was kind of in one ear and out the other,” said Coffin. “I didn’t think much of it again until it was brought back up in an appointment with my oncologist after I was done with treatment.”
In September 2024, with Coffin’s breast cancer treatment officially complete, her oncologist, Rasa Buntinas, MD, with Physicians’ Clinic of Iowa Hematology and Oncology, wanted to have a discussion about the results of the genetic test and schedule a scan to make sure there were none of these tumors. Coffin didn’t know it then, but her and Dr. Buntinas were having a potentially life-saving discussion, because the scan she had soon after revealed two paragangliomas – one in her abdomen and one in her neck.
“This is my why”: Leslie Finds Purpose in Her Diagnosis
After the discovery of the two paragangliomas, Coffin had additional scans which revealed the tumor in her abdomen was sitting too close to her aorta. In conversations with her doctors and surgeons, she learned abdominal paragangliomas tend to be more aggressive in those with SDHB deletion, thus necessitating its removal before it grew closer to her aorta. She had surgery in December and will soon have the tumor in her neck removed as well.
“I know you shouldn’t ask, ‘Why me?’ but I did,” said Coffin. “I had just started a new job, and we had just moved, and I thought why do I have to be going through this?
In one conversation, my paraganglioma surgeon said, ‘had we not caught this when we did, it would have been very problematic. We’d be having a much different conversation,” she added. “And that’s when it hit me. This is my why.”
Coffin is grateful to the team she had around her for guiding her along her journey and providing the treatment and tests she needed at the right time.
“I was lucky because these were found early, and I was lucky because I had the right team,” she said. “I had the right team to say, ‘Hey, Leslie, we need to make this appointment, and you need to get this scan done.’ I owe everyone at St. Luke’s Breast and Bone and the Community Cancer Center a lot more than a thank you. They potentially saved my life.”
Leslie’s Journey Exemplifies the Power of Early Detection
Having seen the benefits of screening and how it leads to detecting cancers in an earlier, more treatable stage, Coffin now passionately advocates for women to stay on top of their routine screening.
“Early detection can save your life. I’m a walking example of early detection,” she said. “Since being diagnosed with cancer and finding the paragangliomas, I’ve had some of the scariest appointments I’ve ever had, but I still walk out of each one so thankful that I have the opportunity to tackle these challenges. Not everyone has that opportunity, and thanks to early detection, I do.”
Experienced Breast Cancer Care and Genetic Testing
If you’ve been diagnosed with breast cancer, or would like to pursue genetic testing, the Nassif Community Cancer is here for you. For more information about the Community Cancer Center and our extensive offering of support services, call (319) 558-4876 or visit communitycancercenter.org.
Get Your Annual Screening Mammogram
It’s recommended women start with a baseline mammogram between the ages of 35-40, then begin annual screening mammograms at age 40, or sooner if there’s a family history of breast cancer. To schedule your mammogram, talk to your healthcare provider or call (319) 369-7216 to schedule your mammogram at one of St. Luke’s Breast and Bone Health’s three convenient locations. St. Luke’s Breast and Bone Health also offers walk-in mammograms Monday through Friday from 9 a.m. – 3 p.m., with a doctor’s order.
