From Baptist Health South Florida
10 min. read
It was 2012 and Tammy Kenhan, a fit and healthy 37-year-old mother of two, was working as a sales representative in the oncology division of a giant pharmaceutical firm, a job she loves as it brings her joy to be part of a team that helps cancer patients lead fulfilling lives.
Little did Mrs. Kenhan know that soon she, too, would face a cancer diagnosis of her own. Roles would now reverse, as she would be the one leaning on others for hope – particularly a team of oncologists and other experts at Baptist Health Miami Cancer Institute. Born and raised in Miami, she would turn to her family and members of her Miami Lakes community for support.
(Watch now: Tammy Kenhan talks about how she uses her experience as a breast cancer survivor to help other women facing a diagnosis. Video by Alcyene de Almeida Rodrigues.)
As someone who promotes the life-saving properties of cancer drugs for a living, Mrs. Kenhan was aware of the prevalence of cancer and the importance of following screening guidelines. Due to her family history, her gynecologist ordered a baseline first mammogram. A year later, the radiologist detected microcalcifications and she eventually underwent a stereotactic biopsy, a needle biopsy that samples the calcifications using mammographic guidance. This biopsy showed atypical or abnormal cells.
Mrs. Kenhan received differing opinions regarding the results and recommendations; one was to watch and wait. “That didn’t sit too well with me,” remarks Mrs. Kenhan. “They found abnormal cells in my biopsy, and they wanted me to just watch and wait? I couldn’t do that. So, I went to get another opinion.”
A second opinion led to a similar finding and recommendation. But Mrs. Kenhan says she still had a persistent feeling that something wasn’t right. “They didn’t think it was cancer, but I felt like I needed to see someone who would really take a deeper look at my case.”
Mrs. Kenhan next sought an opinion with Gladys Giron, M.D., a fellowship trained and board certified breast surgical oncologist at Miami Cancer Institute. Through her work with cancer immunotherapies at her pharmaceutical company, Mrs. Kenhan had heard of Dr. Giron and knew she was highly regarded in her field.
An instant connection
Mrs. Kenhan says that when she first encountered Dr. Giron during a consultation in April 2012, she felt an instant connection. “There was just something about her demeanor,” she says. “I was filled with anxiety and literally bouncing out of my chair in the waiting room because I was so nervous about what was to come.” When Dr. Giron came in, however, Mrs. Kenhan says she felt a sudden and overwhelming sense of calmness.
“She took my hands in hers, looked me in the eye and told me, ‘I know you’re scared but you’re going to be fine. We’re going to get you the right treatment and I’m going to be with you every step of the way.’ That reassurance from her made me feel great. It made me feel safe and it gave me hope.”
Dr. Giron recalls seeing Mrs. Kenhan for the first time. “She’s an amazing woman – she’s like a ray of sunshine. She walks in the room, and you can’t help but immediately feel happy,” Dr. Giron says.
An area of concern
Dr. Giron had reviewed Mrs. Kenhan’s previous studies and saw something that concerned her. Noting that she had dense breast tissue and an increased risk of developing breast cancer due to her family history, Dr. Giron recommended that she get an MRI, something Mrs. Kenhan says no other doctor had suggested previously.
“The MRI revealed an additional area of concern of her right breast, and a biopsy confirmed that she had a Stage I invasive ductal carcinoma,” Dr. Giron says. “Her tumor was estrogen receptor positive and HER 2 negative, and her prognosis was excellent.”
Mrs. Kenhan recalls being so scared at the time. “No matter how much everybody told me that I was going to be okay, I couldn’t help but be very scared,” she admits. “My kids were little – just four and six years old – and the first thing that went through my mind was, ‘Am I not going to see them grow up?’ That was heartbreaking. It was a very, very hard time for me. I didn’t want cancer to take away my time with them.”
A low risk of recurrence
Due to her early stage of disease and tumor characteristics, Mrs. Kenhan was a candidate for breast conservation. She underwent negative genetic testing and, although a mastectomy was not necessary, Dr. Giron discussed all of the different options with her, taking into account her patient’s age, appearance of her breast tissue on radiologic studies and her family history of cancer.
“In line with standard guidelines, the decision was made to proceed with a right mastectomy and a left prophylactic mastectomy,” Dr. Giron says. It was not a decision that Mrs. Kenhan took lightly and much discussion went into reaching it, according to Dr. Giron. “She felt this would afford her the least anxiety in the future and give her the best reconstructive outcome.”
Mrs. Kenhan readily agreed. “Dr. Giron thought this would be the best option for me because I was young and a pretty healthy and fit individual,” she says. “I really didn’t want to have that worry of a recurrence hanging over my every time I had to go get my mammogram and other tests.” She understood, however, that mastectomies do not “100 percent reduce the risk” of ever getting cancer in the area, according to Dr. Giron, as microscopic areas can always remain that are undetectable by even the most advanced diagnostic technologies.
Mrs. Kenhan underwent her surgery, followed by immediate reconstruction with Max Polo, M.D., a plastic surgeon with Baptist Health. “Genomic testing of her tissue determined that her tumor had a low risk of recurrence, such that chemotherapy would not offer a benefit. There was no role for radiation therapy, either,” Dr. Giron notes.
Following surgery, Mrs. Kenhan saw Sara Garrido, M.D., a breast medical oncologist at Miami Cancer Institute, who started her on a five-year regimen of Tamoxifen, an endocrine therapy that competes with estrogen to decrease the risk of developing subsequent cancers.
Treatment is no longer ‘one size fits all’
According to Dr. Giron, since Mrs. Kenhan’s cancer was diagnosed a decade ago there have been several technical advances in breast cancer diagnosis and treatment. “Our imaging has improved. We have 3D mammography, and our ultrasound machines and MRIs are more sophisticated,” she says. “Depending on the cancer, our medical oncologists have a broader array of targeted therapies at their disposal. Genetic testing has really expanded – we’ve discovered many other genes that could potentially contribute to the development of breast cancer.”
Dr. Giron notes that the process of breast reconstruction following surgery has also evolved. “The implants that are used for reconstruction are better quality and patients have greater satisfaction with the results,” she notes.
The biggest change over the past couple of decades, says Dr. Giron, lies in how breast cancer treatment has become highly personalized. “We no longer have a ‘one size fits all’ approach. You can have the same exact pathology report in three different patients and the treatment recommendations may differ for each one, taking into account multiple factors,” she explains.
Oncologists across all subspecialties recognize the importance of looking at the person as a whole. “We don’t just look at the imaging or the physical exam findings,” she says. “We want to look at the family history and social aspects of the patient’s life. We also consider if they meet the criteria for genetic testing.”
Don’t confuse screening with prevention
For Breast Cancer Awareness Month, Dr. Giron encourages women to proceed with their yearly screening mammograms starting at age 40. “Don’t be afraid of a potential finding – make sure you get your mammogram,” she advises. “And if you do have symptoms that are concerning you, don’t ignore them – see your primary care physician or your gynecologist. This way if needed, you can receive the appropriate treatment. Mrs. Kenhan is a poster child for early detection – it really does lead to better outcomes.”
Dr. Giron cautions women not to confuse mammograms or other screening tests with prevention. “I’ve had so many patients say to me upon diagnosis, ‘I don’t understand, I get my mammogram every year. How could this happen to me?’ But remember, a screening study – whether it’s a mammogram or a colonoscopy – is a study that is performed on a patient who is asymptomatic. And the reason for the screening is that we want to detect a disease before there are signs and symptoms. Screening studies do not prevent disease.”
Dr. Giron emphasizes that, while a mammogram won’t prevent a breast cancer from developing, “It is going to help us find it at an earlier stage and a smaller size, which is associated with a better prognosis.”
Sharing her journey with others
Ten years after her diagnosis, Mrs. Kenhan says her goal is to continue helping women who are facing their own cancer journey. “It makes such a difference to someone who’s been diagnosed with cancer to know that there’s someone there who knows what you’re going through and can offer you hope and show you that you will get to the other side,” she says.
Mrs. Kenhan also supports 305 Pink Pack, a local non-profit organization that helps female cancer patients cover the cost of childcare, groceries and rides to their treatments. “One of the toughest things when you’re going through a cancer diagnosis is finding care for your kids and finding someone to help you,” says Mrs. Kenhan. “305 Pink Pack helped me when I needed them, and I give back to that organization as much as I can.”
Every day is a blessing
Mrs. Kenhan says her cancer journey has caused her to reevaluate a lot of things in her life. “I don’t take things for granted anymore, and I’ve definitely learned to not sweat the small stuff. That’s an easy trap to fall into when you’re a busy parent but we really do have to enjoy every day because every day really is a blessing.”
Mrs. Kenhan has a strong sense of gratitude and credits her deep faith for carrying her through her journey. “I would be nothing without my faith. It continues to carry me,” she says, adding that she’s actually glad that she was diagnosed at such a young age. “It has allowed me to live these past 10 years more freely, really enjoying every moment and celebrating every occasion,” she says. “Just waking up and being healthy every day is a celebration. My hope is that I continue to live a healthy life and that I get to see my kids graduate from college and move onto successful careers.”
The third time was the charm
Anyone who has ever faced a serious medical diagnosis knows how challenging it can be to run around town gathering your medical records and seeing different doctors. But Mrs. Kenhan will tell you that she’s glad she made the effort.
“It took a third opinion to save my life. If Dr. Giron hadn’t ordered that MRI, who knows what would have happened,” Mrs. Kenhan says. “If I would have just watched and waited like the other doctors had suggested, my cancer would have progressed even further by the time it was detected, and my treatment options would have been more limited.”
Sara Garrido, M.D., breast medical oncologist at Miami Cancer Institute
If there is a finding during a mammogram or other test, Mrs. Kenhan advises people that if they don’t feel comfortable with the treatment plan the physician is proposing, there is nothing wrong with getting another opinion. “This is your health – your life – and you’re the only one who can fight for it, so you have to be on top of it,” she says.
Mrs. Kenhan adds that she could never thank Dr. Giron enough for what she did for her, and credits her for digging deeper and seeing something in her case. “She did exactly what she promised. She made sure I got the right tests, the right assessments, and the right treatments. But even more than that, she just brought me so much peace when she was with me.”
Mrs. Kenhan has been a great advocate for Miami Cancer Institute, according to Dr. Giron, always letting people in the community know that they should be getting their screenings mammograms and referring patients to the Institute. She also makes a point of speaking with other patients and helping them feel better about their diagnosis.
“The minute she completed her treatment here, all she wanted to do was start giving back,” Dr. Giron says. “She has such a positive attitude, which she maintained throughout her treatment. She’s an amazing woman and a real inspiration. I’m very honored to have been her physician all this time.”
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