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A Self-Exam Led to Jolting Breast Cancer Diagnosis: ‘You have to Find Joy in Every Little Step’
4 min. read
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Baptist Health Miami Cancer Institute
Jocy Nerey, 47, a pre-K teacher in Miami-Dade for nearly 20 years, has always been diligent about her annual medical check-ups, including mammograms. Then – at the height of the COVID pandemic in 2021 – she felt a lump in her breast. At first, it did not surprise her.
“I was a few months behind in my checkups, no more than six months, and I happened to feel a lump in my breast,” she recalls. “I was like: Ok, I've had this before. I have very dense breasts and there are lots of cysts, and no big deal. I didn't think much about it, but I was aware of my body.” In November 2021, her gynecologist urged her to get a biopsy.
Ms. Nerey would turn to Cristina Lopez Peñalver, M.D. breast cancer surgeon at Baptist Health Miami Cancer Institute. She had been a patient of Dr. Lopez Peñalver years earlier when she was treated for benign cysts in her breast. They were both anticipating similar results of benign cysts. But the diagnosis would be sharply different this time.
(Watch video: Hear from patient Jocy Nerey and Cristina Lopez Peñalver, M.D. breast cancer surgeon at Baptist Health Miami Cancer Institute.)
Recalls Ms. Nerey: “Now, we fast-forward to 2021 and I'm back to see her. She did the biopsy. And on December 1st, I came to the office and I heard the words -- I have cancer.”
That was the beginning of a grueling several months that encompassed surgeries, targeted chemo and radiation therapies – and complications from an infection during the reconstructive process that followed a double mastectomy.
“The word ‘cancer’ is so scary,” said Ms. Nerey, who has a 15-year-old daughter, a 19-year-old son and a “wonderful, supportive” husband. “I've done everything. I’ve always been on time with my mammograms and I’m always very aware of my body and what I feel and then -- I got cancer.”
Ms. Nerey adds that she was very fortunate to be under the guidance of Dr. Lopez Peñalver and the breast cancer teams at Miami Cancer Institute. “She is amazing. She said: ‘We've got this,’ with a calm voice. ‘You've got this. You have options. We have treatments for this. You're going to be okay’ … And there’s the amazing teams here at Miami Cancer Institute.”
Cristina Lopez Peñalver, M.D. breast cancer surgeon at Baptist Health Miami Cancer Institute.
Dr. Lopez Peñalver explains that additional imaging “showed much more extensive disease than was evident on the mammogram and the ultrasound.” After additional biopsies, she was diagnosed with multiple cancers in one breast and atypical lesions in both breasts. “At that point, she chose to have a bilateral mastectomy. She definitely needed a mastectomy on the affected side, but she chose to have a contralateral prophylactic mastectomy because she had high-risk lesions as well.”
There was another distinction that would call for a targeted chemo therapy. Dr. Lopez Peñalver said at least one of her cancerous growths expressed HER2, a protein that helps breast cancer cells grow quickly. Breast cancer cells with higher-than-normal levels of HER2 are called HER2-positive. These cancers tend to grow and spread faster than breast cancers that are HER2-negative -- but are much more likely to respond to treatment with drugs that target the HER2 protein.”
Ms. Nerey also had a complicated chemo-radiation course because of an infection that developed following her initial reconstruction surgery, which is atypical and has prolonged the reconstructive process.
“Infections with breast reconstruction are not that common but they can happen,” explained Dr. Lopez Peñalver. “When you're getting chemotherapy, the chemotherapy lowers your immune system and patients are more prone to infections. And since she was relatively recent from surgery, and she had a foreign body with the tissue expanders that were placed at the time of her surgery for the reconstruction, she developed an infection in the opposite breast -- the right breast that was not cancerous but was diagnosed with atypical lesions.”
Despite the challenges, Ms. Nerey’s positive attitude has gotten her through all therapies with success.
“It took a while to get there, but she's cancer-free,” said Dr. Lopez Peñalver. “She's amazing. She's had complications. She's had infections. She's been on antibiotics, sometimes for a whole month, and she's always managed to maintain a positive attitude. She's always smiling. She always looks at the silver lining. And that makes a difference. That makes a huge difference in how patients do.”
Ms. Nerey advises breast cancer patients to stay positive with every step in their ever-evolving treatment and recovery journeys.
“As a cancer patient, I had to learn to be patient,” she says. “Lots of patience because things change and it's not always what you think it's going to be. And that's okay because you want to make sure you get on that right path to make sure that all the cancer is gone.
“You have to find joy in every little step in a cancer journey because it's not easy. Chemo wasn't easy. You have good days and okay days. There's never a great day. But with the support that I had from my husband, from my children, from my family, from friends, from my doctors and the team here at Miami Cancer Institute, I was able to move forward – baby steps every day.”
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