Thriving Beyond Breast Cancer: A Young Survivor’s Journey

Earlier this year, when University of Miami Miller School of Medicine Ph.D. candidate LaShae Rolle discovered a lump in her breast, she wasn’t especially concerned. After all, she was a healthy 26-year-old with no family history of breast cancer.  

Rolle assumed the growth was benign, but to be safe, she went to the student center for a referral to Sylvester Comprehensive Cancer Center, part of the University of Miami Health System. To her surprise, the mammogram and a follow-up ultrasound led to the diagnosis of multicentric breast cancer, a rare type of breast cancer that occurs when two or more tumors form separately in different quadrants of the breast, separated by normal breast tissue.

“I have a background in epidemiology,” says Rolle, whose area of study is cancer disparities in marginalized, minority communities. After being diagnosed, she learned that adolescents and young adults (AYAs) are an underserved group. Less than 1% of females under age 30 are ever diagnosed with breast cancer, she says. “But that is around 84,000 in the U.S. annually.” From now on, says Rolle, AYAs will be included in all her research and community efforts.

“I had no risk factors,” says the Nassau, Bahamas native. After the diagnosis, she underwent genetic testing and was negative for all 70 mutations, says Rolle, the first in her family to be diagnosed with breast cancer. Also, the normal risk factors did not line up with her. While AYAs aren’t candidates for breast cancer screening, “if I had waited to age 45,” says Rolle, “I wouldn’t have made it.” This makes a strong argument, she says, for self-exams.

First, Rolle underwent a simple unilateral mastectomy and then completed chemotherapy. Most recently, she has begun a course of proton radiation.

AYA cancer survivors face many decisions that must be made fast.

According to the American Cancer Society, the fertility rate among young breast cancer survivors is lower than in the general population. “In a split second, I had to decide if I wanted kids,” Rolle recalls.

She chose to have her eggs harvested. While she felt fortunate to have resources and experts to help her navigate, she could imagine the loneliness and despair faced by other AYAs with breast cancer who are as young as 15.

AYAs, says Rolle, are likely to receive more intense breast cancer treatments because their cancer may be more advanced and aggressive. Also, AYAs may have a higher likelihood of reoccurrence simply because they have a greater life expectancy.  Rolle is grateful for the AYA support group at Sylvester. “They helped me get out of the funk and make decisions,” she says.

Rolle is participating in two clinical trials at Sylvester.

In one, Sophia George, Ph.D., a researcher and associate professor of obstetrics, gynecology and reproductive sciences at the Miller School, looks at the link between cancer and Caribbean and African ancestry.

In the second, Frank J. Penedo, Ph.D., associate director for population sciences and director of cancer survivorship and supportive care at Sylvester, is looking at cancer and mental health.

“They take blood and tissue samples, and they test to see if there is some genetic mutation unique to Caribbean or African ancestry,” says Rolle of Dr. George’s study. Dr. Penedo is developing a tool to improve the mental health of cancer survivors.

“LaShae has always been driven to study and understand how to make cancer care equitable,” says Rolle’s primary mentor, Tracy Crane, Ph.D., R.D.N., co-leader of the cancer research program and director of Lifestyle Medicine, Prevention and Digital Health at Sylvester and associate professor of medical oncology and public health at the Miller School of Medicine. “Having been through the experience she has a different perspective and will be able to better design trials and studies.”

According to Dr. Crane, Rolle has continued to publish papers and has not fallen behind in her Ph.D. work. “I am a pretty seasoned researcher,” she says, “and working with LaShae has been a learning experience for me.”

Building strength through physical fitness

Rolle played college basketball. Afterward, she sought a new exercise routine that wouldn’t be time-consuming. She became a powerlifter. Soon, she was winning competitions and competed in the USA Powerlifting Raw Nationals in September. “We know that exercise can improve side effects of chemo and radiation,” says Rolle. “It can improve your mental health, too.”

After the diagnosis, while looking at social media, Rolle observed that no one was showing AYAs with cancer how hard they should work out. She saw an overall lack of advice for the AYA breast cancer community. “I want to be that person,” she says, “so when you look for it, you find it.” Rolle shares videos of her powerlifting and other aspects of her cancer journey on her Instagram, @strongaftercancer.

Because breast cancer screening for AYAs will not begin anytime soon, Rolle offers this advice to adolescents and young adults: “Get to know your body. My pediatrician taught me at age 10 to do a self-breast exam. I got to know my breasts. It wasn’t difficult.”

Long before she was diagnosed with breast cancer, Rolle wanted to be an advocate for cancer research. “Even though this is terrible now, I understand what people are going through, and I want to go out and motivate them to help other survivors.”

Louis Greenstein is a contributing writer for Sylvester Comprehensive Cancer Center.

Tags: Dr. Frank Penedo, Dr. Sophia George, Dr. Tracy Crane, patient profile, rare cancer care, Sylvester Comprehensive Cancer Center