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

The incidence of breast cancer in the Philippines continues to rise, making it one of the most pressing health problems 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 in women.

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

“In the past decade, breast cancer awareness programs—led by health care institutions, human rights organizations, and the public and private sectors—have greatly improved public understanding of screening, early detection, timely consultation, and prompt treatment,” said Philippine Cancer Society President Dr. Corazon A. Ngelangel. “More women are now realizing the value of breast self-exams, clinical breast exams, ultrasound imaging/mammography, and early biopsy appointments.”

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

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

A retired IT project manager aged 60, Mrs. Gesmundo had built a strict routine in his life. She had been doing 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 to check regularly,” said Ms. Gesmundo. “It was something I was committed to.”

It was during one of the routine tests that doctors discovered the change. The lump that was previously monitored had grown, and another appeared near her lymph node, to renew the biopsy immediately.

“Two days after the ultrasound, the doctor called me again, that’s when I realized something was different.”

Then she was diagnosed with breast cancer at a young age.

Made for precision

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

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

“What is important now is that these types are more curable than before,” explained the oncologist, Dr. Emmeline Cua de los Santos. “We’re looking for treatments and better chemotherapy options.”

This shift reflects a broader shift in oncology: from one-size-fits-all treatment to 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, highlighting, “We see firsthand that new things, such as improved imaging techniques, less invasive biopsy procedures, reduction of major procedures such as breast-conserving surgery and sentinel lymph node procedures, and procedures that help patients get more accurate diagnoses.

The role of genomics

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

“We’re going to enter the era of personalized medicine—we’re looking at molecular genetics that determine what’s best for a patient based on their DNA,” said oncologist Dr. Frances Victoria Que.

Besides confirming the presence of cancer, today’s diagnosis aims to understand how the tumor behaves. This includes identifying mutations, protein expression, and risk of recurrence—factors that directly influence treatment planning.

“For every patient, we assess their risk over time,” explained Dr. Que. “From there, we decide whether a treatment like chemotherapy will really bring a benefit.”

With this new approach, patients are now classified into risk categories, allowing oncologists to tailor treatment accordingly.

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

In the case of Ms. Gesmundo, the genomic test was a turning point in his cancer journey.

After his diagnosis, he underwent a precise genomic test used to determine the possibility of cancer recurrence. The results classified him as low risk, meaning he could safely avoid chemotherapy.

“That was very important to me,” he recalled. “I saw how difficult it is for my father to undergo chemotherapy, so if I can get through it, I hope it will be this.”

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

That feeling of validation extended beyond Ms. Gesmundo himself. She also underwent genetic testing to see if her cancer could be passed on to her children. The results came back negative.

Navigational therapy

Although genomics informs treatment decisions, physicians emphasize that care remains a collaborative process—one that combines clinical expertise, patient preferences, and emotional readiness.

“Everything is not equal,” said Dr. de Los Santos. “We plan the right treatment based on the type of cancer, its stage, and what is best for the patient, considering what gives us peace of mind.”

This includes a variety of options: from breast-conserving surgery to total mastectomy, as well as less invasive procedures such as sentinel lymph node biopsy. Advances in oncoplastic surgery now allow patients with large tumors to preserve their breasts while ensuring effective cancer control. Systemic therapies are then superimposed on this surgical foundation.

By investigating a person’s genetic profile, we can tailor treatment.

Awareness, skepticism, and misinformation

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

“There is still a lot of false information about cancer,” he explained. “A lot of people think it’s a death sentence, when in fact, early stage cancer is usually very curable—or curable.”

“Doubt or fear will not take you anywhere, it may ruin your life,” he emphasized.

From survival to empowerment

The journey of Ms. Gesmundo’s cancer has reshaped his vision in lasting ways.

“What you really have now,” he thought. “You learn to be kind to others and to yourself.”

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

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

“As women, especially mothers, we tend to take everything,” she said. “But you also need to take care of yourself, because if you do, you’ll be better able to take care of the people you love. You always choose how you deal with it. Choose to see the good—even when it’s hard.”

Doctors reinforce this message by emphasizing that the combination of early detection, advanced diagnosis, and personalized treatment has changed the face of breast cancer.

Mrs. Gesmundo 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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