High Breast Cancer Risk: How Early Detection Changed One Woman’s Story
Breast cancer was part of Paula Zelaya’s story long before it became her diagnosis.
With a mother diagnosed at just 32, Zelaya was considered high risk. She began screening in her 20s and, over the years, underwent multiple biopsies and had several breast nodules removed.
“I understood my family history and my risk,” says Zelaya. “I never stopped getting checked.”
Her longtime oncologist, Alejandra Perez, M.D., began managing Zelaya’s care when she was just 22, guiding her through years of screenings and procedures at Sylvester Comprehensive Cancer Center, part of UHealth – University of Miami Health System.
By her late 30s, Zelaya was undergoing imaging every six months to detect subtle changes as early as possible.
“Family history can be a powerful warning sign, even when genetic testing is negative,” says Dr. Perez, medical director of the Braman Family Breast Cancer Institute at Sylvester Plantation. “Women at elevated risk may need earlier, more frequent or additional screening. The goal is to create a personalized plan and adjust it as their risk evolves.”
High risk leads to diagnosis
In May 2025, Zelaya felt a lump. An MRI-guided biopsy confirmed what she had spent decades trying to prevent: breast cancer.
“I was terrified,” she says. “But nothing was harder than telling my daughters.”
Her three daughters, then 10, 14, and 16, were suddenly facing the generational threat Zelaya had spent decades trying to outrun. Despite her own fear, Zelaya leaned into the expertise of her multidisciplinary team at Sylvester and reassured her girls that she was in the safest hands possible.
“I trusted my team completely,” she says. “They treated me as a mother and a person, not just a clinical case.”
Because the cancer was caught early, Zelaya did not need chemotherapy or radiation. Instead, she underwent a double mastectomy, followed several months later by reconstructive surgery performed by Juan Rodolfo Mella-Catinchi, M.D., M.P.H., associate professor of surgery at the Miller School.
Recovery forced Zelaya to surrender the independence she prized. Her husband, daughters and friends stepped in to help with daily tasks.
“I had always been the caregiver,” she says. “For the first time, I had to let others care for me.”
A new normal to navigate
Zelaya is slowly returning to her new normal. Because her cancer was hormone receptor-positive, she is taking tamoxifen, a hormonal therapy. For an active 43-year-old, the medication brought another adjustment.
“It feels like being pushed into menopause overnight,” she says. “Your body, your energy and your mental clarity all change.”
While her physical wounds healed, the emotional recovery proved just as demanding.
“Everyone expects you to bounce back after surgery,” says Zelaya. “In reality, you’re learning how to navigate an entirely new normal while managing the constant fear of recurrence.”
Dr. Perez says Zelaya’s experience underscores why high-risk patients need personalized, lifelong surveillance.
“Risk-reduction strategies can lower the chances of developing cancer, but they cannot eliminate the risk,” says Dr. Perez. “That’s why early detection is so important. Finding cancer at its earliest stage can mean less intensive treatment and a better chance for a favorable outcome.”
Fear turns into action
Today, Zelaya uses her experience to empower others. She shares her story on television, podcasts and at speaking engagements, with a particular focus on breaking through health taboos in the Hispanic community. Women often tell her that hearing her story prompted them to schedule overdue screenings.
“I’m honest about what I’ve been through, and women recognize themselves in my story,” she says. “Sometimes that’s all it takes to make someone stop putting off her health.”
Her message is direct: Prioritize yourself.
“Most women spend their lives taking care of everyone else,” she says. “Know your family history, know your risk, talk to your doctor and keep your appointments. Don’t put yourself last.”
She also encourages newly diagnosed patients to take an active role in their care.
“Find a medical team you trust,” she says. “Ask hard questions, understand your options, and allow people to help you.”
On Sept. 26, Zelaya will be honored at the Miami Hurricanes football “Pink Game.” For her, the stadium spotlight is more than a celebration of survivorship. It is an opportunity to reach another woman who may be delaying care.
“Every time I share my story, I hope it prompts action,” she says. “If it gets one woman to schedule her screening, it could save her life.”
Written by Debby Teich. Reviewed by Alejandra Perez, M.D.
Tags: breast cancer early detection, breast cancer risk factors, breast cancer screening, early-stage breast cancer, family history of breast cancer, high-risk breast cancer screening, personalized breast cancer screening
