Rather than using her usual soap and a loofah in the shower, Charlenne Miranda picked up some shower gel. It was a move that she credits with saving her life. The slick surface enabled her to feel a bump in her armpit that hadn’t been noticed during an annual women’s exam three months earlier. It was cancer.
In May of 2020, at age 39, Ms. Miranda was diagnosed with the most common type of breast cancer ― invasive ductal cancer. It begins in a milk duct and invades nearby tissues. “My tumor was the size of a small key lime,” said the Coral Springs resident. “I’d had a baby at Boca Raton Regional Hospital just nine months earlier. I never imagined I would be there for surgery for breast cancer.”
Ms. Miranda’s experience highlights the importance of breast self-exam, said medical oncologist Jane Skelton, M.D. , with Boca Raton Regional’s Lynn Cancer Institute , part of Baptist Health South Florida. “She felt something unusual, that hadn’t been present a few months earlier, and wisely sought immediate attention,” Dr. Skelton said.
A Treatment Plan
After her diagnosis and to help develop a treatment plan, Ms. Miranda met her team at the Multimodality Clinic at Lynn Cancer Institute. “I call it speed dating for doctors,” Ms. Miranda said. “You sit in one place and every 20 minutes or so, another oncology specialist comes to you. This is so that they can discuss the best plan of care with their expert group.”
At the Clinic, Ms. Miranda said she was put at ease, in spite of a frightening diagnosis. “As I sat with the doctors, scared and terrified, Dr. Skelton turned to me after explaining everything and said, ‘Enough about what I think. What do you want to do?’ This is how I knew I picked the right oncologist and the right place for my care.”
Ms. Miranda does have a history of breast cancer in her family. Both of her grandmothers were diagnosed as older adults, but her mother was diagnosed at age 48. Counseling and testing at the Morgan Pressel Center for Cancer Genetics  at Lynn Cancer Institute did not reveal any known inherited gene mutations that carry a high risk of cancer. She did, however, have an abnormality, but geneticists don’t know of a link to cancer at this point.
Because of her tumor’s make-up and its aggressiveness, doctors recommended she undergo neoadjuvant chemotherapy ― chemo given before surgery to reduce the size of the tumor and to prevent metastasis, or spread, of the disease.
Chemo Does Its Job
Although Ms. Miranda had a severe reaction to one of her chemotherapy medications and had to end chemo earlier than expected, the outcome was good.
“There was a huge shrinkage in the tumor,” Dr. Skelton explained. “There was a very small residual cancer left.”
On Sept. 28, 2020, Joseph Colletta, M.D. , performed a bilateral mastectomy. In addition, five lymph nodes were removed.
Ms. Miranda was in the hospital one night, but was anxious to get home to Lucas, who was 14 months old at the time, and to Carina, who was 7. “Not to be able to hold my baby was heartbreaking. But my husband is awesome and my parents and in-laws came to help.”
Physical therapy at Gloria Drummond Physical Rehabilitation Institute at Boca Regional Hospital  helped with mobility and pain after the bilateral mastectomy and lymph node removal surgery. Ms. Miranda’s physical therapist, Ruth Light, PT, CLT-LANA, part of a specialized team of lymphedema and breast cancer rehabilitation specialists, explained: “Charlene was very motivated to regain her strength and range of motion so she could return to her prior exercise programs and to keep up with her young children.” This past January, Ms. Miranda had reconstructive surgery. “My hair is growing back. I look better, I feel better, I’m able to exercise more.”
Enrolled in a Clinical Trial
Following her recovery, Ms. Miranda met with radiation oncologist Rashmi Benda, M.D. , who told her she was eligible to be part of a clinical trial offered at Lynn Cancer Institute to determine if more harm than good is being done by giving radiation to patients, like Ms. Miranda, who have positive lymph nodes prior to surgery, but whose lymph nodes are found to be clean at surgery. “She went over all the pros and cons with me and I decided to do it.”
Ms. Miranda was randomly placed in the arm of the study where no radiation is given. She is comfortable with her decision because participating in the study also means she will be closely followed so that if any recurrence were to happen, it would be caught early.
Wisdom from a Survivor
Today, she encourages all women to regularly perform breast self-exams and to do it occasionally in the shower with gel. “This isn’t a dress rehearsal for life,” she said. “This is life or death. Be your own advocate and don’t delay your care.”