ROJoson PEP Talk: Breast Cancer Awareness Month - October 2022

1. Empowerment
objective - for
laypeople to have an
awareness or
understanding of
fundamentals and
generalities of
BREAST CANCER in
their health
management.
October 22, 2022
1400H - 1500H
Via Zoom
Breast Cancer
Awareness
Month –
October 2022

2. Empowerment
objective - for
laypeople to have an
awareness or
understanding of
fundamentals and
generalities of
BREAST CANCER in
their health
management.
Breast Cancer
Awareness
Month –
October 2022
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

3. There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

4. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.

5. Empowerment
objective - for
laypeople to have an
awareness or
understanding of
fundamentals and
generalities of
BREAST CANCER in
their health
management.
Breast Cancer
Awareness
Month –
October 2022
My PEP TALK today is
entitled:
Breast Cancer
Awareness Month
– October 2022.

6. Contents:
• When is Breast Cancer Awareness Month in the
Philippines?
• What are the objectives of Breast Cancer Awareness
Month?
• How do we observe Breast Cancer Awareness Month?
You and Me?
• What are ROJoson’s specific contributions to the Breast
Cancer Awareness Month in the Philippines in 2022?
• What are the objectives, target impact and target
outcome of the ROJoson PEP Talk on Breast Cancer
Awareness Month?
• What are the focused contents of ROJoson PEP Talk on
Breast Cancer Awareness?
• Recognition of ROJoson Breast Cancer Survivors
Will give another
outline on this.
Breast Cancer
Awareness
Month –
October 2022

7. When is the Breast Cancer Awareness Month in
the Philippines?
Breast Cancer
Awareness
Month –
October 2022

8. When is the Breast Cancer Awareness Month in
the Philippines?
Breast Cancer
Awareness
Month –
October 2022
October of each year is being observed as the
Breast Cancer Awareness Month.
Not only in the Philippines but also all over the
world.
Started in 1985 in the USA – then all over the
world – as breast cancer is the most common
worldwide.

9. When is the Breast Cancer Awareness Month in
the Philippines?
Breast Cancer
Awareness
Month –
October 2022
The pink ribbon is an international
symbol of breast cancer awareness. Wearing a pink ribbon is a
manifestation of:
• Support of Breast
Cancer Awareness.
• Having and promoting
awareness of the
importance of
controlling breast
cancer as a health
problem in the
community and in the
world.

10. What are the objectives of Breast Cancer
Awareness Month?
Breast Cancer
Awareness
Month –
October 2022

11. What are the objectives of Breast Cancer
Awareness Month?
Breast Cancer
Awareness
Month –
October 2022
• To raise awareness.
• To empower the laypeople.
on
• BREAST CANCER (what is it / how to prevent
if possible / how to recognize early / how
treated / what is the prognosis / etc.)
• How the burden of breast cancer can be
controlled in the family and community
(Lessen the number of Filipinos dying and
suffering from breast cancer because of late
consult and treatment.)
4Ks of Patient
Empowerment:
• KAALAMAN
(knowledge and
understanding)
• KAKAYANAN
(capability)
• KARAPATAN (rights)
• KAPANGYARIHAN
(self-
determination)

12. How do we observe Breast Cancer Awareness
Month? You and Me?
Breast Cancer
Awareness
Month –
October 2022

13. How do we observe Breast Cancer Awareness
Month? You and Me?
Breast Cancer
Awareness
Month –
October 2022
YOU
– Make efforts to know what is breast cancer; how to prevent if
possible; how to recognize early; how treated; and prognosis.
• Read.
• Attend lectures / talks provided by DOH and other agencies (and
ROJoson PEP Talk).
– Examine your body for a possible breast cancer.
• Do a self-examination of your breasts.
• Consult a physician for a check or if you have symptoms of breast
disorder.

14. How do we observe Breast Cancer Awareness
Month? You and Me?
Breast Cancer
Awareness
Month –
October 2022
YOU
– Make efforts to know what is breast cancer; how to
prevent if possible; how to recognize early; how treated;
and prognosis.
• Read.
• Attend lectures / talks provided by DOH and other
agencies (and ROJoson PEP Talk).
– Examine your body for a possible breast cancer.
• Do a self-examination of your breasts.
• Consult a physician for a check or if you have symptoms
of breast disorder.
If you do all these,
you are
EMPOWERING
YOURSELF.
You are contributing
to the goal of the
Awareness Month –
LESSEN the number
of Filipinos suffering
and dying from
breast cancer.

15. How do we observe Breast Cancer Awareness
Month? You and Me?
Breast Cancer
Awareness
Month –
October 2022
ME – ROJoson
What are ROJoson’s specific contributions to the
Breast Cancer Awareness Month in the
Philippines in 2022?
ROJoson PEP Talk on Breast Cancer AWARENESS -
Patient Empowerment Program (Education for
Health Development in the Philippines)
This will be my
contribution in 2022.

16. • What are ROJoson’s specific contributions to
the Breast Cancer Awareness Month in the
Philippines in 2022?
Breast Cancer
Awareness
Month –
October 2022
ROJoson PEP Talk on Breast Cancer
AWARENESS - Patient Empowerment
Program (Education for Health
Development in the Philippines)
This will be my
contribution in 2022.

17. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
I will align my PEP Talk with the objectives of the
national or Department of Health (DOH)
program.
However, I will try to make my PEP Talk down-to-
earth (reasonable, simple and practical, cost-
effective-efficient, etc.), hopefully, to better
achieve the impact of the national or DOH
program.
This will be my
contribution in 2022.

18. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
I will target at least 10 Filipinos who will pass the
ROJ-OCIL-OLETE on Breast Cancer Awareness.
This will serve as one of the key performance
indicators of my contribution.
So, my request ----- pls. take and pass the OLETE.
This will be my
contribution in 2022.

19. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
My objectives will be the following:
• To create awareness among Filipinos on breast
cancer for those who are still not aware.
• To create more awareness among Filipinos on
breast cancer for those who have some
knowledge already on breast cancer.
• At least on the following: what is breast
cancer; how to prevent if possible; how to
recognize early; how treated; and prognosis.
This will be my
contribution in 2022.
What are the objectives,
target impact and target
outcome of the ROJoson
PEP Talk on Breast
Cancer Awareness
Month?

20. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
My objectives will be the following:
• To create awareness among Filipinos on breast
cancer for those who are still not aware.
• To create more awareness among Filipinos on
breast cancer for those who have some
knowledge already on breast cancer.
• At least on the following: what is breast
cancer; how to prevent if possible; how to
recognize early; how treated; and prognosis. This will be my
contribution in 2022.
This awareness will be measured by my OLETE
(Online Learning cum Evaluation Test Exercise).
So, pls. take the OLETE and help me achieve my
objectives.
What are the objectives,
target impact and target
outcome of the ROJoson
PEP Talk on Breast
Cancer Awareness
Month?

21. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
My targeted IMPACT:
Through EDUCATION and PATIENT
EMPOWERMENT,
• Lessen the number of Filipinos dying and
suffering from breast cancer because of late
consult and treatment.
I will promote early diagnosis and
treatment in my PEP Talk. This will be my
contribution in 2022.
What are the objectives,
target impact and target
outcome of the ROJoson
PEP Talk on Breast
Cancer Awareness
Month?

22. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
My targeted IMPACT:
Through EDUCATION and PATIENT
EMPOWERMENT,
• Lessen the number of Filipinos dying and
suffering from breast cancer because of late
consult and treatment.
I will promote early diagnosis and
treatment in my PEP Talk.
The impact cannot be to
save ALL! To prevent
death in ALL! To prevent
suffering in ALL!
THIS IS UNREALISTIC! It
cannot be 100%.
LESSENING the number
is more realistic and
reasonable.
Thus, the realistic and
reasonable strategy is to
promote early consult
and early treatment to
lessen number of death
and suffering.

23. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
My targeted IMPACT:
Through EDUCATION and PATIENT
EMPOWERMENT,
• Lessen the number of Filipinos dying and
suffering from breast cancer because of late
consult and treatment.
I will promote early diagnosis and
treatment in my PEP Talk.
I have to confess that I will
NOT be able to measure
the impact of my PEP Talk
adequately as it takes a
long time to see the
impact (YEARS!)
What I can just do are to
count the number of my
OLETE passers who
hopefully practice what
they learn – early
recognition, consult and
treatment and, of course,
count and review my
breast cancer survivors.

24. ROJoson PEP Talk on Breast Cancer AWARENESS
Breast Cancer
Awareness
Month –
October 2022
My targeted OUTCOME:
At least 10 FILIPINOS ARE EMPOWERED based on
the OLETE results.
At least 10 FILIPINOS pass the OLETE on what is
breast cancer; how to prevent if possible; how to
recognize early; how treated; and prognosis.
So, pls. take the OLETE and help me achieve my
targeted OUTCOME.
What are the objectives,
target impact and target
outcome of the ROJoson
PEP Talk on Breast
Cancer Awareness
Month?

25. What are the focused contents of ROJoson PEP
Talk on Breast Cancer Awareness Month for the
Filipinos?
Breast Cancer
Awareness
Month –
October 2022

26. What are the focused contents of ROJoson PEP
Talk on Breast Cancer Awareness?
Breast Cancer
Awareness
Month –
October 2022
• What is a breast cancer?
• What are the causes of breast cancer? Ways to prevent
breast cancer? Behaviors of breast cancer?
• When to suspect one may have breast cancer?
• How to self-screen for breast cancer? How to do self-
examination of the breast?
• What are the consequences of breast cancers if not
diagnosed and treated early?
• What cost-effective diagnostic tests are usually being
done for breast cancer suspect?
• What are the usual treatment for breast cancer?
• What is prognosis after treatment for majority of breast
cancer and with early treatment?

27. What is a breast cancer?
Breast Cancer
Awareness
Month –
October 2022

28. What is a breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Breast cancer is cancer originating in the breast.
Breast cancer is a medical disease when some of
the breast cells grow uncontrollably with a
potential to invade the adjacent body tissues or
organs and to spread to distant tissues or organs.

29. What is a breast cancer?
Breast Cancer
Awareness
Month –
October 2022
A breast cancer usually presents as a solid tumor
not liquid tumor.
It is also known as breast malignancy or
malignant tumor of the breast.
(To differentiate it from benign tumor of the
breast which does not invade and spread.)

30. What is a breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Breast cancer is the most common cancer in the
world and in the Philippines (both sexes) –
GLOBOCAN, 2020
It is more common in females than in males
(100:1).
It is more common in older than younger
females (usually about 40 years old and older).

31. What is a breast cancer?
Breast Cancer
Awareness
Month –
October 2022
There are so many types of breast cancer.
NOT all breast cancers are the same.
There are at least more than 20 different types.
Some have track records of being fast-growing
and some, slow-growing (therefore, associated
with good prognosis or outcome).

32. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Up to the present time, the exact cause or
mechanism for cancer development is not yet
known. So, realistically speaking, there is really
no known absolute way for prevention.
In 90 to 95% of cases, nobody knows the exact
cause as most of the time, the cause is
multifactorial.
In only 5 to 10% are breast cancers due to
inherited gene mutation from parents.
90 to 95% are “sporadic.”

33. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Breast cancers develop through multiple factors
such as genetic predisposition; environmental
factors including lifestyle; and aging that it is
difficult to identify a sure-shot specific strategy
of prevention.

34. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
There are some things that can increase the risk
of cancer that we can't change.
These include things like damaged DNA inherited
from a parent; family history; and getting older.

35. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Though managing certain controllable risk
factors – such as diet, physical activity and other
lifestyle choices – can lower your chances of
developing breast cancer,
But NO guarantee – best effort!

36. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Uncontrollable risk factors:
• Female
• Aging
• Family history of breast cancers
• History of breast cancer on one breast
• Inherited breast cancer genes from parents

37. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Controllable risk factors:
• Being overweight and obese
• Lacking adequate amount of exercise
• Drinking alcohol excessively
• Using hormone replacement therapy
• Smoking tobacco or exposing to tobacco
smoke
• Exposing to excessive radiation particularly
to the chest

38. What are the causes of breast cancer? Ways to
prevent breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Cancer Prevention - Mitigation Tips on Controllable Risk
Factors:
1. Maintain a healthy weight.
2. Have adequate amount of exercise.
3. Drink alcohol in moderation.
4. Limit use of hormone replacement therapy.
5. Avoid exposure to tobacco smoke.
6. Avoid excessive radiation exposure.
7. Eat healthy diet (more of plant-based diet)
8. Be in touch with reliable medical information on
breast cancer risk and prevention.

39. What are the behaviors of breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Once a breast cancer develops, it has the
potential to grow and invade or infiltrate
adjacent organs or tissues and also the potential
to spread to distant sites in the body.
The rate of growth and spread of the cancer is
dependent primarily on the behavior of the
mutated genes and secondarily on the presence
of promoting factors in the person’s body like
medications and hormonal levels and in the
environment like cancer-causing chemicals.

40. What are the behaviors of breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Once a breast cancer develops, it has the
potential to grow and invade or infiltrate
adjacent organs or tissues.

41. What are the behaviors of breast cancer?
Breast Cancer
Awareness
Month –
October 2022
The most common regional site of spread is the
armpit lymph node.
The more common distant sites of spread are:
• Bone
• Lungs
• Brain
• Liver

42. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
ALERT SYMPTOMS or SYMPTOM-CUES for
BREAST CANCER:
• Breast mass
• Change in breast contour
• Nipple retraction
• Nipple-areolar skin erosion
• Nipple discharge – red
• Armpit mass
Pain per se without the above associated alert
symptoms is NOT a symptom-cue for breast
cancer.

43. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
The commonest starting point in suspecting
breast cancer is the palpation of a mass on the
breast.
Although not all
breast masses are
cancers, presence of
a breast mass is a
RED FLAG.
This must be
evaluated by a breast
surgeon.

44. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
BREAST MASS:
Foremost in the physical examination is
to look for a dominant mass, the real mass, the
mass which is considered as the red flag, meaning, if
present, it needs at least more investigation.
One should distinguish dominant mass from
prominent or un-smooth breast tissues which
are usually part of fibrocystic changes, which is
considered normal and does not require surgical
treatment.

45. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022

46. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Diagnostic algorithm in patients with a
dominant breast mass:
Look for signs of inflammation and
infection (pus, erythema, tenderness,
fluctuancy of mass) – if present, primary
diagnosis is inflammatory or infectious
mass – ABSCESS

47. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Diagnostic algorithm in patients with a dominant
breast mass:
Look for signs of malignancy (signs of
local invasion – ill-defined border,
fixation, retraction, ulceration, fungation;
signs of spread – axillary lymph nodes) - if
present, suspect MALIGNANT MASS.

48. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Diagnostic algorithm in patients with a dominant
breast mass:
Look for signs of malignancy (signs of
local invasion – ill-defined border,
fixation, retraction, ulceration, fungation;
signs of spread – axillary lymph nodes) - if
present, suspect MALIGNANT MASS.

49. When to suspect one may have breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Diagnostic algorithm in patients with a dominant
breast mass:
If no signs of malignancy – more
likely, BENIGN MASS (especially
if mass is CYSTIC - containing
fluid)

50. How to self-screen for breast cancer? How to do
self-examination of the breast?
Breast Cancer
Awareness
Month –
October 2022

51. How to self-screen for breast cancer?
Breast Cancer
Awareness
Month –
October 2022
Breast self-examination
Monthly.
• Look and feel for anything unusual.
• Look and feel for a dominant mass.
• Look and feel for the other alert signs of
cancer:
• Change in breast contour
• Nipple retraction
• Nipple-areolar skin erosion
• Nipple discharge – red
• Armpit mass

52. How to do self-examination of the breast?
Breast Cancer
Awareness
Month –
October 2022

53. How to do self-examination of the breast?
Breast Cancer
Awareness
Month –
October 2022

54. • What cost-effective diagnostic tests are
usually being done for breast cancer suspect?
Breast Cancer
Awareness
Month –
October 2022

55. • What cost-effective diagnostic tests are
usually being done for breast cancer suspect?
Breast Cancer
Awareness
Month –
October 2022
• Ultrasound
• Mammography
• Needle biopsy (fine needle; core needle)
• Open biopsy
• There are various indications for the
diagnostic tests.
• Choice will be dependent on comparison of
options in terms of benefit, risk, cost and
availability parameters.

56. • What cost-effective diagnostic tests are
usually being done for breast cancer suspect?
Breast Cancer
Awareness
Month –
October 2022
Procedures Benefit (goal –
to be more
definite on the
diagnosis)
Risk Cost Availability
Biopsy Direct info (4+
diagnostic
yield)
Pain PPP
Ultrasound Indirect (2+) No pain P
Mammogra
phy
Indirect (1+) Pain +
Radiation
PP
CT scan Indirect (3+) No pain +
Radiation
PPPP

57. • What are the usual treatment for breast
cancer?
Breast Cancer
Awareness
Month –
October 2022

58. • What are the usual treatment for breast
cancer?
Breast Cancer
Awareness
Month –
October 2022
• Surgery
• Surgery + chemotherapy + hormonal therapy
+ radiotherapy
• Chemotherapy + surgery + radiotherapy +
hormonal therapy
• Others
• Choice will be dependent on comparison of
options in terms of benefit, risk, cost and
availability parameters.

59. • What are the usual treatment for breast
cancer?
Breast Cancer
Awareness
Month –
October 2022 Procedures Benefit (goal of
treatment)
Risk Cost (PhP) Availability
Option1 greatest survival rate acceptable 5000 available
Option2 rate < 1 > 3 acceptable 6000 available
Option3 least survival rate acceptable 3000 available

60. • What is prognosis after treatment for majority
of breast cancer and with early treatment?
Breast Cancer
Awareness
Month –
October 2022

61. • What is prognosis after treatment for majority
of breast cancer and with early treatment?
Breast Cancer
Awareness
Month –
October 2022

62. • What is prognosis after treatment for majority
of breast cancer and with early treatment?
Breast Cancer
Awareness
Month –
October 2022 So, go for early recognition,
diagnosis and surgical
treatment of breast cancer to
have a better chance for cure
and to avoid unwanted
suffering and death!

63. Recognition of ROJoson Breast Cancer Survivors
Breast Cancer
Awareness
Month –
October 2022

64. Recognition of ROJoson Breast Cancer Survivors
ROJoson Registry of Breast Cancer Survivors and
Recognition
Breast Cancer
Awareness
Month –
October 2022

65. ROJoson Registry of Breast Cancer Survivors and
Recognition
Breast Cancer
Awareness
Month –
October 2022
To better convince you of the importance of early
recognition, diagnosis and surgical treatment (and
to inspire you), I will now present to you my
registry of breast cancer survivors whom I have
treated from 1982 up to the present (about 40
years).
Criterion for inclusion in this registry: at least 10
years in remission after a breast cancer treatment
esp after an operation.
NOTE: this is a partial list (not all followed-up).
About 110 Breast
Cancer Survivors in
the Registry
https://sites.google.com/s
ite/rojosonscancersurvivo
rs/home
https://sites.google.com/s
ite/rojosonscancersurvivo
rs2

66. ROJoson Registry of Breast Cancer Survivors and
Recognition
Breast Cancer
Awareness
Month –
October 2022
About 110 Breast Cancer Survivors in the Registry
(range from 10 years to 40 years in remission up
to 2022)
https://sites.google.com/site/rojosonscancersurvivors/ho
me
https://sites.google.com/site/rojosonscancersurvivors2

67. ROJoson Registry of Breast Cancer Survivors and
Recognition
Breast Cancer
Awareness
Month –
October 2022

68. ROJoson Registry of Breast Cancer Survivors and
Recognition
Breast Cancer
Awareness
Month –
October 2022

69. ROJoson Registry of Breast Cancer Survivors and
Recognition
Breast Cancer
Awareness
Month –
October 2022

70. Contents:
• When is Breast Cancer Awareness Month in the
Philippines?
• What are the objectives of Breast Cancer Awareness
Month?
• How do we observe Breast Cancer Awareness Month?
You and Me?
• What are ROJoson’s specific contributions to the Breast
Cancer Awareness Month in the Philippines in 2022?
• What are the objectives, target impact and target
outcome of the ROJoson PEP Talk on Breast Cancer
Awareness Month?
• What are the focused contents of ROJoson PEP Talk on
Breast Cancer Awareness?
• Recognition of ROJoson Breast Cancer Survivors
Will give another
outline on this.
Breast Cancer
Awareness
Month –
October 2022
Summary
Take Away

71. What are the focused contents of ROJoson PEP
Talk on Breast Cancer Awareness?
Breast Cancer
Awareness
Month –
October 2022
• What is a breast cancer?
• What are the causes of breast cancer? Ways to prevent
breast cancer? Behaviors of breast cancer?
• When to suspect one may have breast cancer?
• How to self-screen for breast cancer? How to do self-
examination of the breast?
• What are the consequences of breast cancers if not
diagnosed and treated early?
• What cost-effective diagnostic tests are usually being
done for breast cancer suspect?
• What are the usual treatment for breast cancer?
• What is prognosis after treatment for majority of breast
cancer and with early treatment?
Summary
Take Away

72. Be always in touch with reliable medical
information on BREAST CANCER.
Breast Cancer
Awareness
Month –
October 2022
Take Away in
relation to
Patient
Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of oneself by
knowing the fundamentals and
generalities of BREAST CANCER in health
management.

73. Empowerment
objective - for
laypeople to have an
awareness or
understanding of
fundamentals and
generalities of
BREAST CANCER in
their health
management.
Breast Cancer
Awareness
Month –
October 2022