One in four Filipinos will likely develop breast cancer in their lifetime, and 50 percent of those diagnosed are projected to die from the disease.

With 90 percent of Filipinos choosing mastectomy over any other treatment, falsely believing that removing the breast is the better solution to stop cancer, breast cancer is now not only synonymous with death, but with mutilation, as well.

“There’s an old wives’ tale that says when you develop breast cancer, you lose three things: your breast, your dignity and your life. But that’s no longer true,” said Dr. Norman San Agustin, president and CEO of Asian Breast Center at Centuria Medical Makati, the one-stop, outpatient medical-IT facility at Century City on Kalayaan Avenue corner Salamanca Street, Makati City.

San Agustin is a fellow of the American College of Surgeons and founder and president of Morristown Surgical Associates at the Morristown Medical Center in New Jersey, one of the top five hospitals in the greater New York Metropolitan area, and also among the top 50 hospitals in the United States.

Asian Breast Center, which opened last week, is the country’s first freestanding ambulatory cancer care unit for profit and for charity, dedicated to the comprehensive treatment and management of breast diseases. It is affiliated with the Cancer Program of Morristown Medical Center.

Its partnership with Morristown—difficult cases will be presented to the board at Morristown, he said—means the center is constantly held to a higher standard.

Integrity

One of its main thrusts is preserving not only the patient’s life, but also her integrity as a woman. That means preserving the breast as much as possible.

In the US, San Agustin said, 90 percent of breast surgeries are breast-sparing procedures, yet breast cancer claims only 10 percent of those afflicted with the disease.

Unfortunately, Filipinos wrongly believe that removing the entire breast will give better results. Mastectomy is widely practiced in the country not because women prefer it, but because women feel they have no better alternative.

With all things equal—age, cancer stage, tumor size, tumor type, receptor type—the outcomes of a mastectomy and a lumpectomy are exactly the same, San Agustin said.

“The fact is, mastectomy and lumpectomy have the same survival rate. That’s a fallacy among Filipinos—they think they’re free of cancer after a mastectomy, but the reality is there are still many ducts and nodules in there,” San Agustin said.

Doctors cannot remove all the glands in the body since they are located under the skin. If doctors shave off everything, the skin becomes gangrenous and necrosis (death of the skin tissue) occurs. The little fat left in the skin is critical, because that contains the vascular elements that will supply oxygen to the skin. And all it needs for cancer to return is one dot, one nodule.

San Agustin said Filipinos may also be turned off by lumpectomy due to the radiation therapy that’s required after. Daily radiation for six-and-a-half weeks means long hours waiting in traffic and queuing in the hospital. So they opt for mastectomy without fully understanding its devastating implications. Filipinos, he said, take for granted the cosmetic part of the surgery.

A way to avoid the lengthy, tedious process of radiation therapy after a lumpectomy is now available in the center with the state-of-the-art Intraoperative Radiation Therapy (IORT).

A first in the Philippines, the innovative radiation treatment provides a single dose of radiation for 25-30 minutes immediately after a lumpectomy while the patient is still asleep. What normally takes 33 daily sessions to complete one cycle now only takes one session.

“While you’re asleep we remove the lump, insert the device, radiate for 20-30 minutes, sew the incision, then you can go home. You go back to work within six days, and only go back to see your doctor for follow-ups, not treatments,” he said.

Spared

IORT also involves radiating only the surrounding tissue, not the entire breast, after the tumor is removed. This means healthy organs and tissue, such as the lungs or ribs, will be spared from radiation.

Another breakthrough, yet again a first in the Philippines, is Molecular Breast Imaging (MBI), a machine so powerful it can detect breast cancer in patients with dense breasts. Asians, owing to their smaller-sized breasts, have dense breasts and, therefore, increased risk of breast cancer.
Having dense breasts means having more nonfatty tissues than fatty tissues, so they make it harder for mammograms to detect breast cancer.

Fatty tissues look dark in mammograms, while dense breast tissues look white. Unfortunately, tumors also appear white on mammograms, making it hard for doctors to distinguish.

MBI is a new nuclear medicine technique that makes cancer cells highly visible. A small dye or tracer will be injected into the patient’s vein which accumulates in malignant cells, making it appear brighter than benign cells. MBI is faster and less costly than an MRI, and with a mammogram, it can detect breast cancer four times more efficiently than mammogram alone.

“We are among the few in the world to offer MBI,” San Agustin said.

Asian Breast Center offers early breast cancer treatment consultation with internationally trained and accredited breast surgeons, as well as medical oncology, radiation oncology, minor breast surgeries, breast reconstruction, diagnostic modalities, digital mammography, breast ultrasound, scintigraphy and biopsy.

It has preventive care, early detection and treatment including early screening tests, radiation therapy, breast and cosmetology services, counseling, patient education, and close post-operative follow-up supportive services. There is also nutritional and psychological support.

As a for-profit, for-charity center, one of its missions is to provide the same type of treatment for every woman, rich or poor. It is working with La Salle Dasmariñas charity clinic, where it is helping provide manpower and equipment.

“The greatest tragedy is when a woman dies from a disease that is curable,” San Agustin said.

The Asian Breast Center is open Mondays to Saturdays, 8 a.m.-5 p.m. Visit www.centuriamedical.com.ph. Call 0917-1BREAST, 8630616, 8630617. E-mail [email protected].