From early detection to personalized treatment: Navigating breast cancer with care

The incidence of breast cancer in the Philippines continues to rise, positioning it as one of the most urgent health concerns among Filipino women today. In 2022, the World Health Organization Global Cancer Observatory recorded 33,079 new cases in the country, making it the most common cancer among women.

Despite these numbers, medical experts emphasize that the narrative around breast cancer is changing—from one being defined by fear to one increasingly shaped by early detection, precision medicine, and survivorship.

“Over the past decade, breast cancer awareness intiatives—led by healthcare institutions, advocacy groups, and both public and private sectors—have significantly improved the public’s understanding of screening, early detection, timely consultation, and prompt treatment,” Philippine Cancer Society President Dr. Corazon A. Ngelangel said. “More women now recognize the importance of breast self-examination, clinical breast examination, screening imaging via ultrasound/mammography, and prompt diagnostic biopsy consult.”

“Particularly, with early detection, survival rates continue to improve,” Dr. Ngelangel added. “And patients now have access to more personalized and evidence-based treatment strategies than ever before, aided by foundational tools in precision medicine.”

For patients like Jocelyn Gesmundo, early detection is life-changing.

A retired IT project manager at 60, Ms. Gesmundo had already built a disciplined routine around her health. She had undergone regular mammograms and ultrasounds for more than 15 years, motivated by a strong family history of cancer.

“When I became a mother, I made sure I did regular checkups,” Ms. Gesmundo shared. “It was something I committed to.”

It was during one of the routine screenings that doctors detected a change. A previously monitored lump had grown, and another appeared near her lymph node, prompting immediate biopsy.

“Two days after my ultrasound, the doctor called me back. That’s when I knew something was different.”

She then was diagnosed early-stage breast cancer.

Personalized for precision

Breast cancer diagnosis today relies on what clinicians call triple assessment: a combination of clinical examination, imaging (such as mammography or ultrasound), and biopsy confirmation.

Beyond diagnosis, the classification of breast cancer has also become more sophisticated. There are three major subtypes: hormone receptor-positive, HER2-positive, and triple-negative breast cancer, each requiring distinct treatment strategies.

“What’s important now is that these types are much more treatable than before,” surgical oncologist Dr. Emmeline Cua delos Santos explains. “We have targeted therapies and better chemotherapy options.”

This shift reflects a broader transformation in oncology: the move away from one-size-fits-all treatment towards personalized, evidence-based care.

As Dr. Jose Rhoel C. de Leon, one of the board of directors at the Philippine College of Surgeons Cancer Commission Foundation, highlights, “We are seeing firsthand how innovations, such as improved imaging techniques, minimally invasive biopsy procedures, de-escalation of radical procedures like breast conserving surgery and sentinel lymph node procedures, as well as precision diagnostics are helping patients receive more accurate diagnoses and tailored surgical management.”

The role of genomics

At the heart of modern breast cancer care is a major shift: from standardized treatment protocols to highly individualized care.

“We’re going towards the era of personalized medicine—looking at molecular components that determine what is best for a patient based on their DNA,” said medical oncologist Dr. Frances Victoria Que.

Beyond confirming the presence of cancer, today’s diagnostics aim to understand how a tumor behaves. This includes identifying mutations, protein expressions, and recurrence risks—factors that directly influence treatment planning.

“For every patient, we assess their risk over time,” Dr. Que explains. “From there, we determine whether treatments like chemotherapy will actually provide benefit.”

With this new approach, patients are now stratified into risk categories, allowing oncologists to de-escalate treatment accordingly.

Early breast cancer patients with small tumors that are hormone receptor positive and HER2 negative can be tested if their genomic profile points to low risk. “If a patient is low-risk based on genomic testing, we can safely skip it [chemotherapy] and proceed with less aggressive treatment,” Dr. Que emphasized. A healthy discussion with doctors is important.

In Ms. Gesmundo’s case, genomic testing became a turning point in her cancer journey.

After her diagnosis, she underwent a precision genomic test used to determine the likelihood of cancer recurrence. The results classified her as low risk, meaning she could safely avoid chemotherapy.

“That was very important to me,” she recalled. “I saw how difficult chemotherapy was for my father. So, if there was something I could skip, I hope it would be that.”

“A cancer diagnosis brings a lot of anxiety,” Dr. Que said. “But when patients are given clear, personalized treatment plans, it helps reduce that uncertainty and gives them a sense of control.”

That sense of reassurance extended beyond Ms. Gesmundo herself. She also underwent genetic testing to determine whether her cancer could be passed on to her children. The results came back negative.

Navigating treatments

While genomics informs treatment decisions, doctors stress that care remains a collaborative process—one that integrates clinical expertise, patient preferences, and emotional readiness.

“It’s no longer one-size-fits all,” said Dr. de Los Santos. “We tailor-fit treatment based on the type of cancer, its stage, and what is best for the patient, even considering what gives them peace of mind.”

This includes a wide range of options: from breast-conserving surgery to full mastectomy, as well as less invasive procedures such as sentinel lymph node biopsy. Advances in oncoplastic surgery now even allow patients with larger tumors to preserve their breasts while ensuring effective cancer control. Systemic treatments are then layered onto this surgical foundation.

By investigating the individual’s genomic profile, we can tailor fit the treatment.

Awareness, hesitancy, and misinformation

Despite these advancements, however, one of the biggest challenges in breast cancer care remains awareness. Misconceptions about breast cancer contributes to delays in screening and diagnosis, Dr. Que observed.

“There’s still a lot of misinformation surrounding cancer,” she explained. “Many people think it’s a death sentence, when in reality, early-stage cancers are often very treatable—or even curable.”

“The hesitancy or fear will not get you anywhere, it may even cost your life,” she emphasized.

From survival to empowerment

Ms. Gesmundo’s cancer journey has reshaped her outlook in lasting ways.

“What you really have is the present,” she reflected. “You learn to be kinder to others and to yourself.”

Her days are now marked by intentional living: spending time with family and reconnecting with friends.

She also offers a reminder often forgotten in conversations about women’s health: the importance of self-care.

“As women, especially mothers, we tend to take on everything,” she said. “But you also need to take care of yourself. Because, when you do, you’re better able to care for the people you love. You always have a choice in how you face it. Choose to see the positive—even if it’s difficult.”

Doctors reinforce this message by emphasizing that the convergence of early detection, advanced diagnostics, and personalized treatment has transformed the breast cancer landscape.

Ms. Gesmundo, for her part, leaves a message of urgency and hope.

“Make sure you get tested. The earlier this is detected, the better the prognosis.”

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