October is Breast Cancer Awareness Month, and we were honored to talk with LaToya Bolds-Johnson, PA-C, a wife, mom, emergency medicine PA and breast cancer survivor, about her experience as a health care provider, a patient, and her plea to all women.
Bolds-Johnson was diagnosed with triple negative breast cancer in July 2021. She felt a lump in her breast but thought it was an enlarged milk gland because she had recently stopped breast-feeding. When the lump didn’t go away, her physician ordered a mammogram.
Before her diagnosis, the mammogram technician was hesitant to perform a mammogram due to Bolds-Johnson’s age and family history – she was 36 at the time and didn’t have a known family history of breast cancer. Eventually, a biopsy was recommended, which made her very nervous. She went ahead with the biopsy and hoped it was just a benign milk cyst, but it wasn’t.
“I received a notification on my phone while I was working in the emergency department,” said Bolds-Johnson. “I clicked on the notification thinking it was a basic lab report and the words ‘triple negative breast cancer, high grade three’ popped up on my phone screen.”
She left work that day distraught and in disbelief.
Triple negative breast cancer is the most aggressive form of breast cancer with higher incidence in African American women. Compared with non-Hispanic White women, Black women have an 81% higher rate of triple-negative breast cancer. Due to socioeconomic factors, Black women face barriers to standard care, advance treatment, and inclusion in clinical trials.
“We [Black women] have a higher mortality rate from triple negative breast cancer compared to White women. We are being diagnosed at later stages and dying at much higher rates.”
Bolds-Johnson could not practice clinically after she began chemotherapy. As an emergency medicine PA, working in the emergency department during the COVID-19 pandemic was an occupational hazard because she was immunocompromised.
“Becoming a patient has been the most difficult aspect of my breast cancer journey,” said Bolds-Johnson. “I felt defeated as a PA because I was so used to being the caregiver.”
At the young age of 4, Bolds-Johnson knew she wanted to be a health care provider. She met and shadowed an orthopaedic PA in her sophomore year of college and decided on a career as PA. Ten years into the profession, Bolds-Johnson misses being able to practice, but is fiercely committed to raising awareness about triple negative breast cancer in Black women and barriers to care.
“Black women are not being offered the opportunity to participate in clinical trials or receiving the best optimal treatment. Representation matters, and we need more diversity in clinical trials, so we know how to effectively treat this cancer with life-saving drugs.”
When asked how PAs can support breast cancer screening, Bolds-Johnson wants her colleagues to become more familiar with atypical and typical breast cancer symptoms. “We need to reframe our medical decision-making capacity by not just ordering routine mammograms for women over 40,” she said. “High-risk screenings are crucial for patients of minority groups at earlier ages.”
“I want ALL women to know you don’t have to be 40 years old to have a mammogram. Know your family history and be proactive about self-breast exams. And most importantly, advocate for yourself!”
Bolds-Johnson has three daughters and is inspired to help them and other women who may develop breast cancer. She uses her personal social media channels to raise awareness about earlier detection of breast cancer. Visit her LinkedIn page to learn more.
Ismail Jatoi, M.D., Ph.D., Hyuna Sung, Ph.D., and Ahmedin Jemal, D.V.M., Ph.D. The Emergence of Racial Disparity in U.S. Breast-Cancer Mortality. N Engl J Med 2022; 386:2349-2352 DOI: 10.1056/NEJMp2200244
 Siddharth S, Sharma D. Racial Disparity and Triple-Negative Breast Cancer in African American Women: A Multifaceted Affair between Obesity, Biology, and Socioeconomic Determinants. Cancers (Basel). 2018 Dec 14;10(12):514. doi: 10.3390/cancers10120514. PMID: 30558195; PMCID: PMC6316530.