‘Here’s How I Knew I Had Breast Cancer’: One Survivor’s Story Following a Slightly Delayed Mammogram

It’s better to get your mammogram a little late than to miss it altogether, right? Absolutely—but this story will illustrate that in some cases, time truly is of the essence.

Breast cancer remains the leading type of cancer among women in the United States. In 2024, the American Cancer Society estimates that more than 310,720 women will be diagnosed with invasive breast cancer, plus 56,500 cases of ductal carcinoma in situ (DCIS), a relatively less aggressive form of breast cancer. Unfortunately, in 2024 breast cancer is expected to claim the lives of approximately 42,250 women.

You are probably familiar with the hallmark signs of breast cancer, which include but are not limited to feeling a lump in the breast, changes in the skin or nipple area, experiencing nipple discharge, or seeing an indentation in the skin. However, Wassim Mchayleh, MD, MBA, FACP, who’s a medical oncologist at AdventHealth and Clinical Program Director for the Breast Cancer Program at the Central Florida Division, makes an important point about breast cancer symptom awareness and early detection: “It’s important to say that we don’t want to wait for the symptoms,” Dr. Mchayleh says. “Breast cancer is better diagnosed with a mammogram before having any symptoms.”

This breast oncologist emphasizes the value of self-examinations and clinical breast exams by a healthcare professional, but he highlights that the recommended test to diagnose breast cancer is a mammogram with or without ultrasound for an earlier and more accurate breast cancer diagnosis, with standard screening starting at the age of 40. (Note: The U.S. Preventive Services Task Force recommends that women at average breast cancer risk begin mammogram screenings at age 40 and continue every two years until age 74. Women with a mother or birth sister who had breast cancer should start screenings 10 years earlier than the age at which their relative was diagnosed.)

Dr. Mchayleh also addresses a misconception to clarify that most breast cancer cases are not genetic, despite widespread belief. Genetic forms of breast cancer constitute only about 5% of cases. He notes that while the general risk of breast cancer is about 11% to 12% for women, this risk doubles with a first-degree relative diagnosed, and triples or quadruples with more than two first-degree relatives. In some instances, such as for women with dense breasts or a high-risk profile (over 20% risk), adding an ultrasound or breast MRI to the screening process is advised.

Dr. Mchayleh warns that while most cancers develop over a period of six to 12 months, the more aggressive types can emerge between regular mammogram screenings. Because of this, it is essential to seek further evaluation if you detect any changes in your breasts, even after a negative mammogram, given the diversity of breast cancer types: Estrogen receptor-positive (the most common that grows in response to estrogen), HER2-positive and triple-negative (which are more aggressive).

The story of breast cancer survivor Simona Lazinsk highlights the importance of early detection. Now 46, Lazinsk was diagnosed at age 41 with a HER2-amplified tumor after seeking a second opinion with Dr. Mchayleh and the AdventHealth team. Their practice uses a care model they call the Breast Cancer Multidisciplinary Clinic, which in one appointment gathers the patient and several specialists—in Simona’s case, a surgical oncologist, medical oncologist, and radiation oncologist—all at the same time to evaluate newly diagnosed breast cancer patients and develop a personalized care plan together. This innovative approach ensures timely patient evaluation, encourages specialist collaboration, standardizes care, and expedites treatment initiation, leading to overall improved patient outcomes and survival rates. Dr. Mchayleh says his team has seen improved outcomes exceeding the national average using this particular model.

In Simona’s case, this collaboration and thought-sharing between doctors was especially beneficial because starting chemotherapy before surgery can optimize a breast cancer prognosis. This contrasts with scenarios at other hospitals, where patients might first undergo surgery before seeing an oncologist.

Continue reading Simona’s breast cancer survival story to understand why making sure that mammogram is finally scheduled can be lifesaving.

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Here’s how I knew I had breast cancer

By Simona Lazinsk, as told to Dr. Patricia Varacallo, DO

My journey to America began when I was just a young girl. Originally from Guyana in South America, my family harbored dreams of a better life in the United States. Upon our arrival, my mother dedicated herself to our home, while my father, despite holding a PhD and a career as a professor, found his qualifications unrecognized. Consequently, he worked tirelessly in a restaurant to support us.

Over time, even though our living situation began to improve, things didn’t get easier. My mother was diagnosed with pancreatic cancer, and after a two-year fight, she passed away at age 53. Devastated, my father succumbed to alcohol, and my sister passed away as well.

In an attempt to escape the memories that South Florida held of my mother, I relocated to Central Florida, leaving everything behind and immersing myself in my real estate career. It was also in this field that I met my future husband, though our romantic relationship did not begin until years later—on Valentine’s Day 2019, he proposed center court of an Orlando Magic game to mark what we expected would be a joyous new chapter in our lives.

It so happened that my life was so busy around this time that I postponed scheduling my first mammogram in 2019 at age 40. It didn’t help months later when the Covid pandemic struck and many healthcare organizations put all elective procedures on hold. As I’d find out, getting a mammogram that year would have been insightful.

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Finding a lump on my breast

In March of that same year, I found myself on a business trip to Chicago. Realizing I had forgotten my personal shower gel and loofah, I resigned myself to using the hotel’s soap. It was then, while washing, that I discovered a small lump on my right breast. Initially, I brushed it off as a possible pimple, though of course concern lingered in the back of my mind.

In my hotel room I turned to the internet to search for symptoms of breast cancer, finding that only the lump itself seemed to fit the profile. I didn’t have the other symptoms—like nipple discharge, nipple inversion, breast irritation—but I promised myself I’d schedule an appointment with my primary care doctor when I got home. That was one of several checkups I’d let slip when the pandemic started.

When I called her practice, they couldn’t get me in for another month. I didn’t want to alarm my fiancé but mentioned it to him. He was glad I was getting it checked out.

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My breast cancer diagnosis

During my appointment with my primary care doctor, she reassured me the bump was likely nothing serious but advised me to go for a mammogram just to be sure.

Scheduling the mammogram was easy. Most hospital systems have a designated line to call, and often they can get you in within a couple days or a few weeks at most.

After my mammogram, I learned some concerns had been discovered. The radiologist who read my imaging suggested that I undergo an ultrasound for a closer look.

The ultrasound results raised more alarms, leading to a biopsy next. The biopsy procedure—particularly the unexpectedly large needle involved—was a bit intimidating, and the doctors’ questions heightened my own questions and fears. I also underwent a breast MRI for further clarification.

After the biopsy results came back, I received the call from my doctor: I had breast cancer, she said. I was genuinely shocked. My doctor instructed me not to wait: My cancer was classified as stage one but grade three, meaning the cancer was highly aggressive.

I remember hanging up the phone feeling stunned…then tears started to flow. I remember thinking: Would I make it to my next birthday?

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Seeking a second opinion

My primary care doctor had recommended an oncologist in Orlando. My first impression of this doctor was striking. He entered the room with a certain briskness, which was especially jarring after having just gotten such serious news about my health. As I sat there in my hospital gown, looking down, he began outlining my diagnosis and treatment plan in a rather matter-of-fact manner without offering explanations or pausing for my input. He quickly mentioned chemotherapy, radiation, and surgery as my treatment pathway.

When I asked for clarification, especially about the necessity of chemotherapy before surgery, he responded, “Because that’s what we do.” This answer surprised me. I listened to my gut and hurried to seek opinions from other breast cancer specialists, searching for someone who could explain the treatment in a way that resonated with me.

This search brought me to the team at AdventHealth Altamonte Springs, led by Dr. Devina McCray, a breast surgical oncologist, and Dr. Mchayleh. These two physicians took the time to thoroughly explain the treatment process and the advantage to me as a patient of having all necessary doctors in one location through their multi-disciplinary model to treat breast cancer.

Being able to consult with my oncologist, surgeon, and radiation oncologist under one roof in just one afternoon was incredibly beneficial. Facing cancer treatment is overwhelming enough without the added stress of commuting between multiple offices and not feeling confident that your doctor will be sensitive to your questions.

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Treatment after I knew I had breast cancer

Given the aggressive nature of my cancer, my doctors recommended starting with chemotherapy to ensure the cancer hadn’t spread to other areas of my body. My chemotherapy regimen consisted of the medications Perjeta, Herceptin (trastuzumab), and docetaxel. This is the first-line treatment for HER2+ breast cancer that has metastasized. Even though my cancer hadn’t yet metastasized, which means “spread,” my doctors told me it was highly aggressive which meant that it was likely to spread soon. It was a tough journey, undergoing eight rounds of chemo before surgery.

Following chemotherapy, in August of 2019—so much had happened in the six months after my fiancé had proposed!—I underwent a double mastectomy with Dr. McCray. I decided against radiation, having witnessed the profound impact it had on my mother during her fight with pancreatic cancer. It was a personal choice that I felt was right for me in my healing journey.

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Life after breast cancer

Today, I am doing great! This year marks a significant milestone—five years cancer-free. My visits to the doctor and blood work have become a regular part of my life every six months, and I just had an appointment with Dr. Mchayleh recently. I’ve come to view these doctors as family.

It’s a blessing, truly, to have reached this side of my journey. I’m happily married, have published my autobiography and was crowned Mrs. Central Florida and Ms. Florida International. Life blooms, even after cancer—something hard to imagine in the thick of the battle, but profoundly true.

Remember that if you’re ever uncertain or uncomfortable with your care, seeking a second opinion is always an option.

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