Why Mammograms Matter: She Had Cancer in Both Breasts and Didn't Even Know

Sandra Sher remembers the exact thought she had walking from her car into the imaging center one December morning in 2020. “I’m healthy,” she told herself. “And when I come back to the car, let’s see if I’m still healthy.”

She had no symptoms. No lumps she could feel. No pain. Just a routine mammogram, the kind she’d had many times before. But that ordinary appointment changed everything.

The scan revealed cancer in her right breast. Then, after a closer look, doctors found something entirely different in her left breast. Ms. Sher, a 76-year-old retired teacher from Boca Raton, had two separate cancers at the same time.

“I had a double whammy,” she says, pointing first to her right breast and then her left one. “Breast cancer here, lymphoma there — both at the same time.”

(Watch now: When Sandra Sher of Boca Raton went in for a routine mammogram, she left with a diagnosis that was doubly troubling: invasive ductal carcinoma in one breast, lymphoma in the other. Today, thanks to the multidisciplinary care she received at Lynn Cancer Institute at Boca Raton Regional Hospital, she’s feeling fabulous and grateful. Video by Alcyene de Almeida Rodrigues.)

A Rare and Surprising Diagnosis

In her right breast, Ms. Sher had invasive ductal carcinoma, the most common form of breast cancer. It was HER2-positive, an aggressive type. On her left side, doctors discovered marginal zone lymphoma, a rare cancer of the breast.

“Sandy had a very specific case,” explains Youssef Zeidan, M.D., a radiation oncologist at Lynn Cancer Institute, part of Baptist Health, at Boca Raton Regional Hospital. “Around 80 percent of breast cancers are ductal. The surprise in her case was that, during her workup, a spot was seen on the other breast, and on biopsy it came back as a form of lymphoma.”

Being diagnosed with cancer in both breasts at once is uncommon. Dr. Zeidan estimates it happens in only about two percent of early-stage breast cancer cases.

“It’s fairly rare for a breast cancer patient to present with bilateral synchronous tumors,” he says. “Because we’re a high-volume center, we see the common cases but we also see the unusual ones, like lymphoma of the breast.”

When Ms. Sher first heard the word “cancer,” the news didn’t sink in right away.

“I was just numb,” she says. “You hear it but your brain doesn’t process it.” The moment it became real arrived with a different word. “When I heard ‘chemo’ — boom! That means you lose your hair.” She knew then that her diagnosis was all too real.

A Treatment Plan Built Around Her

Ms. Sher’s care followed the multidisciplinary approach Lynn Cancer Institute uses for every breast cancer patient. Specialists in surgery, medical oncology, radiation oncology, genetics and other fields worked together to map her path forward.

Her plan included a lumpectomy with a sentinel lymph node biopsy — performed by now-retired breast surgeon Joseph A. Colletta, M.D., with the Christine E. Lynn Women’s Health & Wellness Institute at Boca Raton Regional Hospital — followed by chemotherapy under the care of Naomi G. Dempsey, M.D., and radiation therapy under the care of Dr. Zeidan.

Because her right-sided tumor was HER2-positive, she also received trastuzumab (Herceptin), a targeted antibody that has dramatically improved survival for patients with this type of breast cancer.

Radiation for Both Breasts

Ms. Sher’s two cancers raised an unusual question for her radiation oncology team.

“We were faced with the question: should we treat both breasts separately or at the same time?” Dr. Zeidan recalls. “Given the precision of the radiation technology available at Lynn Cancer Institute, we recommended treating both breasts simultaneously and Ms. Sher readily agreed.”

That decision spared Ms. Sher from having to undergo two separate rounds of radiation. Her course lasted four weeks, five days a week, just minutes per session. The lymphoma, it turned out, responded especially well.

“Luckily, marginal zone lymphomas tend to be very radiation-sensitive,” Dr. Zeidan explains. “The lymphoma didn’t need surgery. We could rely on radiation therapy.”

Ms. Sher sailed through with minimal side effects, mostly fatigue and mild skin irritation.

“She recovered nicely,” Dr. Zeidan says, “especially for somebody who underwent treatment to both breasts at the same time.”

Ms. Sher puts it more plainly. “I was one lucky girl. I had my strength, and I was able to resume my activities.”

Lifting Other Cancer Patients

If you’d visited Lynn Cancer Institute’s infusion center or its waiting area during Ms. Sher’s treatments, you might have spotted her comforting other patients. It was something that wasn’t part of her care plan but nevertheless an important part of her personal cancer journey.

“She was inspirational to other patients,” Dr. Zeidan says. “She helped other patients who were having a stressful time by telling her story and reassuring them that everything was going to be fine once they finished their treatment.”

That kind of encouragement carries a unique power, he adds.

“As physicians, we can counsel patients and reassure them,” Dr. Zeidan says. “But coming from patient to patient, it really hits differently. Patients offer the perspective of somebody who has been through it.”

The Strength to Persevere

Ms. Sher never set out to be an example. She simply showed up each week with the same outlook that has shaped her whole life.

“I’ve always been very positive,” she says. “I got that from my mother, whose ring I wore through every appointment. She gave me the strength to persevere.”

Ms. Sher is quick to turn attention away from herself and toward the people who cared for her.

“I don’t think this should be about me,” she says. “It should be about the people who helped me and saved me, and the nurses in the infusion room. They were just incredible — they became family.”

Ms. Sher also credits her daughter, who lives in nearby Delray Beach and was there for every one of her appointments — listening, taking notes, asking questions and, most importantly, providing encouragement and love.

“She is my heart,” Ms. Sher says.

Where She Stands Today

Dr. Zeidan still sees Ms. Sher every three to six months and he says her outlook is bright.

“Her survival is expected to be more than 90 percent after five years,” he says. “We expect she’ll live a full, long life like any normal woman.”

For Ms. Sher, the experience already feels like a distant memory.

“Going through all that I went through, it’s like a blur,” she says. Now, however, “I’m back to tennis. I’m back to golf and I’m going on with my life. I’m feeling fabulous and I’m feeling grateful.”

The Lesson Behind Her Story

Both Ms. Sher and Dr. Zeidan return to the same point, the one that started it all. A routine mammogram found two cancers before either one caused a single symptom.

“Sandy wouldn’t have known that she had early-stage breast cancer without screening,” Dr. Zeidan says. “I can’t emphasize enough how important screening is. When we detect abnormalities early, surgery is easier, treatment can be less taxing and outcomes are far better.”

His guidance is direct. For women at average risk, a screening mammogram should begin at age 40 and continue once a year. Those with a strong family history or genetic risk may need to start earlier and should talk with their physician about the right schedule.

Ms. Sher’s advice comes from a different place but points to the same truth. She walked in feeling perfectly healthy. Her mammogram found otherwise. And that made all the difference in her becoming a breast cancer survivor.

Click here to learn more about treatments and specialists available at Lynn Cancer Institute at Boca Raton Regional Hospital, part of Baptist Health.