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The Asian Breast Center is Closing—Here's Why It Matters
The 8-year-old facility is caught between its noble mission and harsh realities.
Published on Aug 23, 2025
(SPOT.ph) “I can’t sleep. I feel I threw everything away by coming back," says Dr. Norman Agustin. "At Morristown Medical Center, I was at the height of my career—respected, well paid, part of a system that worked. I gave all of that up because I thought I could make a difference here."
Dr. San Agustin, an accomplished breast oncologist, established one of New Jersey’s top breast care programs, earned a national reputation for surgical precision, and spent decades at the peak of American medicine. But when friends asked when he would give back to his homeland, he eventually walked away.
In the Philippines, the New York–trained surgeon was shaken to find breast cancer killing proportionally more women than in the U.S.—a crisis fueled by late diagnoses and poor access to treatment. His response was bold. In 2017, he opened the Asian Breast Center (ABC), the country’s only specialized ambulatory breast cancer facility. Eight years later, it is shutting down.
In the Philippines, the New York–trained surgeon was shaken to find breast cancer killing proportionally more women than in the U.S.—a crisis fueled by late diagnoses and poor access to treatment. His response was bold. In 2017, he opened the Asian Breast Center (ABC), the country’s only specialized ambulatory breast cancer facility. Eight years later, it is shutting down.
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Dr. Norman San Agustin photographed by Jilson Tiu at the Asian Breast Center in Makati City. Cover design by Warren Espejo.
On September 6, the ABC will have its last day of operation, closing its doors forever, undone by red tape, crushing costs, a market that could not bear its prices, and a misaligned health system.
The ABCs of Running ABC
ABC brought in cutting-edge technology previously unavailable in the Philippines. Intraoperative radiation therapy (IORT) delivered targeted radiation in a single session during surgery, eliminating weeks of post-operative treatment. Molecular breast imaging (MBI) detected cancers in dense breast tissue that mammograms might miss. To reach underserved women, ABC introduced Thermalytix, an AI-powered tool that uses thermal imaging to spot abnormalities—non-invasive, affordable, and radiation-free. All of this was offered in a boutique, world-class setting.
But the center was caught between its noble mission and harsh realities. From the start, it faced long delays in government approvals, heavy debt from costly equipment, and patient bills beyond what most could afford. Despite caring for more than 5,000 patients and extending services to poor communities, ABC could not bridge the gap between its high standards and the country’s limited ability to pay. In the end, red tape, high costs, lack of government support, and a health system stacked against specialized centers forced its shutdown.
But the center was caught between its noble mission and harsh realities. From the start, it faced long delays in government approvals, heavy debt from costly equipment, and patient bills beyond what most could afford. Despite caring for more than 5,000 patients and extending services to poor communities, ABC could not bridge the gap between its high standards and the country’s limited ability to pay. In the end, red tape, high costs, lack of government support, and a health system stacked against specialized centers forced its shutdown.
"When I look around, the people who need care the most are left with nothing," says San Agustin. "They can’t afford treatment, and the healthcare system that should protect them simply isn’t there.”
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Dr. Norman says ambulatory centers can deliver breast cancer care more efficiently. They cost less, shorten wait times, and offer focused, patient-friendly care without long hospital stays or crowded wards. Photograph by Jilson Tiu.
ABC’s first patients were a small circle of affluent women who found the facility through word of mouth. They valued the intimacy of an ambulatory center, the private lounge, and the relief of avoiding long hospital queues. During the pandemic, that trust deepened. With many fearful of crowded hospitals, more patients turned to ABC—sometimes as many as 12 to 16 a day, recalls Leo Santos, ABC’s business development consultant. The clinic even secured a temporary permit to provide chemotherapy.
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A patient goes thru an MBI procedure. Molecular Breast Imaging helps detect cancers often missed in dense breast tissue, an important alternative to mammography and MRI. Photograph by Jilson Tiu.
Still, ABC’s beginnings were plagued by regulatory hurdles. The specialized equipment required lengthy government approvals, forcing the center to wait nearly two years before treating its first patient. During that time, it carried loans and operating costs without revenue, sinking it into debt.
Digital marketing later widened its reach, attracting middle-class patients—65 percent from Metro Manila, the rest from far-flung provinces, often covered by HMOs. Since 2023, the center had conducted Luzon-wide screening missions with Thermalytix. Of the thousands screened, less than a handful could pursue full treatment at ABC. Only two patients are completing therapy—one privately funded, another aided by a foundation. Most visits stopped at screenings and biopsies, citing insufficient funds for operations.
Digital marketing later widened its reach, attracting middle-class patients—65 percent from Metro Manila, the rest from far-flung provinces, often covered by HMOs. Since 2023, the center had conducted Luzon-wide screening missions with Thermalytix. Of the thousands screened, less than a handful could pursue full treatment at ABC. Only two patients are completing therapy—one privately funded, another aided by a foundation. Most visits stopped at screenings and biopsies, citing insufficient funds for operations.
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Dr. Norman stands beside a painting that greets ABC visitors. Photograph by Jilson Tiu.
For Dr. San Agustin, viability lies in PhilHealth recognition. Currently, its “A” package covers prevention (screenings and biopsies), and its “Z” package covers advanced treatments (surgery and chemotherapy) but only in government or hospital settings. Ambulatory surgery centers such as ABC remain excluded.
His case is straightforward: ambulatory centers can deliver breast cancer care more efficiently. They cost less, shorten wait times, and offer focused, patient-friendly care without long hospital stays or crowded wards. He adds, “Thermalytix is the cheapest breast screening machine in the world. A test costs P1,500, compared to P4,700 for a mammogram. It’s internationally approved, and studies show it’s just as accurate. But the healthcare system doesn’t take it seriously. Women in the provinces wait weeks or months in local clinics. By the time they reach a hospital, their cancer is advanced—they’re too weak for treatment or already gone. Private centers like ours are ready to provide this at near cost.”
His case is straightforward: ambulatory centers can deliver breast cancer care more efficiently. They cost less, shorten wait times, and offer focused, patient-friendly care without long hospital stays or crowded wards. He adds, “Thermalytix is the cheapest breast screening machine in the world. A test costs P1,500, compared to P4,700 for a mammogram. It’s internationally approved, and studies show it’s just as accurate. But the healthcare system doesn’t take it seriously. Women in the provinces wait weeks or months in local clinics. By the time they reach a hospital, their cancer is advanced—they’re too weak for treatment or already gone. Private centers like ours are ready to provide this at near cost.”
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A Typical Day
A typical day at ABC is built around personalized care in a close-knit setting. Unlike large hospitals, it operates like a boutique practice where every patient receives individual attention. Days begin with the team reviewing schedules and prepping for procedures. Dr. San Agustin, the chief medical officer, personally greets patients, reinforcing the center’s hands-on ethos.
Patients come for screenings, follow-ups, and—when their finances allow—surgeries. To stay viable, ABC needs at least two surgeries a week but often falls short. Its small staff worked shorter hours in recent months, but always with quality over volume. Each patient has time to understand procedures, weigh options, and feel supported. Registered social workers help them tap public and private aid.
Patients come for screenings, follow-ups, and—when their finances allow—surgeries. To stay viable, ABC needs at least two surgeries a week but often falls short. Its small staff worked shorter hours in recent months, but always with quality over volume. Each patient has time to understand procedures, weigh options, and feel supported. Registered social workers help them tap public and private aid.
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A patient's thermal image is studied by a nurse. Infrared cameras detect heat changes that may point to breast tumors. Photograph by Jilson Tiu.
“One of my patients was a breast cancer survivor who went regularly to Stanford,” recalls Dr. San Agustin. “When her cancer came back, she came to me for surgery. Later, her Stanford doctor admitted there was nothing more they could have done—he even said the Asian Breast Center did an excellent job. Another patient had been treated at Sloan Kettering, the top cancer hospital in the U.S. But when she returned to the Philippines for urgent reasons, she chose surgery with us. We’re equal to some of the best hospitals in America—only far more affordable.”
Operations manager Reydes Pestaño says patients trusted not only Dr. San Agustin’s skill but his presence. One woman, referred by a priest, confesses he was always anxious seeing doctors due to her family history of cancer. In Dr. San Agustin, she found a calm that eased her fears. Upon learning of the ABC closure, she vowed to follow him anywhere he practiced. Even fellow physicians turned patients praised the doctor’s careful, thorough checkups. For Pestaño, these stories show what set him apart: mastery matched by compassion.
Operations manager Reydes Pestaño says patients trusted not only Dr. San Agustin’s skill but his presence. One woman, referred by a priest, confesses he was always anxious seeing doctors due to her family history of cancer. In Dr. San Agustin, she found a calm that eased her fears. Upon learning of the ABC closure, she vowed to follow him anywhere he practiced. Even fellow physicians turned patients praised the doctor’s careful, thorough checkups. For Pestaño, these stories show what set him apart: mastery matched by compassion.
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Dr. Norman at the Century City Mall clinic: Staff say patients like how he relieves their anxiety. Photograph by Jilson Tiu.
The most widely shared case is that of April Perreras, a full-time mother and digital content creator who came in January 2022 on her mother-in-law’s recommendation. She had found a lump and, through HMO coverage, underwent an excision biopsy confirming cancer at another hospital.
At ABC, her first surgery revealed a cavity in her right breast, inside which doctors found another tumor. Because the cancer was invasive, repeated excisions were ruled out. In July 2022, Perreras underwent a bilateral mastectomy with reconstruction, performed the same day.
She also felt reassured by the clinic environment, especially during the COVID surge. “I chose Asian Breast Center over a hospital because it felt safer. It’s very exclusive to breast health, and that gave me peace of mind.”
Her journey reshaped her future. “Because of my experience, I became a certified lymphedema therapist,” she says. “Now I want to help cancer patients suffering from lymphedema after surgery or radiation.”
Her journey reshaped her future. “Because of my experience, I became a certified lymphedema therapist,” she says. “Now I want to help cancer patients suffering from lymphedema after surgery or radiation.”
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Packing up eight years: (Clockwise from top left) clinic coats at the dressing room; clinic staffmember doing inventory; glass ampoules getting ready to be transported to Dr. Norman's Batangas clinic; and one of the rooms at ABC. Photographs by Jilson Tiu
At its core, ABC’s business depended on a high volume of premium procedures. But for most Filipinos, even a biopsy was out of reach. Some opted for public hospitals, others for community clinics, while many unable to afford treatment simply returned home to wait for the end. The market’s reality was far from business expectations.
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"I’m too old to keep pushing when there’s no end in sight,” says Dr. San Agustin. “I went to the government, I reached out to people, even sought help from psychiatrists and psychologists to cope, but still there was no solution." Photograph by Jilson Tiu.
Dr. San Agustin met women with tumors so advanced they had erupted through the skin—raw, gaping, bleeding, foul-smelling wounds. Many arrived ashamed of the odor and disfigurement. For him, these cases reflect a weak healthcare system that forces women to suffer until the disease consumes not just their bodies but their dignity.
“Some women come in with breasts ulcerated, bleeding, infected—you can smell them from meters away….When I ask, ‘When did you first feel the lump?’ they’ll say, ‘Oh, just a week ago.’ But when they unhook their bra, the breast has been rotting for years. That’s denial,” he says. He performs biopsies to confirm the cancer, but costs remain a barrier. Pathology is outsourced, and when reports come, so do bills. If patients can’t pay, the clinic often shoulders costs, sometimes with quiet help from benefactors—never enough to stay afloat.
“Some women come in with breasts ulcerated, bleeding, infected—you can smell them from meters away….When I ask, ‘When did you first feel the lump?’ they’ll say, ‘Oh, just a week ago.’ But when they unhook their bra, the breast has been rotting for years. That’s denial,” he says. He performs biopsies to confirm the cancer, but costs remain a barrier. Pathology is outsourced, and when reports come, so do bills. If patients can’t pay, the clinic often shoulders costs, sometimes with quiet help from benefactors—never enough to stay afloat.
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The Final Hours
In recent months, as resources dwindled and rent lagged, staff kept going mostly through dedication and small contributions—stretching every peso, delaying payments, and making do with less just to keep the doors open.
“The clinic may be winding down, but the advocacy cannot die,” Pestaño says. “I keep praying someone will take over, because I believe in Dr. Norman’s advocacy: early diagnosis saves lives, and cancer is treatable. He treats nurses like family, and grateful patients keep sending food to say thank you. That spirit should not end here.”
“The atmosphere is sad,” adds Santos, noting how close the staff had grown to their patients. Families often brought food to express their appreciation and sympathy, treating nurses like family—making the closure even more painful.
“The clinic may be winding down, but the advocacy cannot die,” Pestaño says. “I keep praying someone will take over, because I believe in Dr. Norman’s advocacy: early diagnosis saves lives, and cancer is treatable. He treats nurses like family, and grateful patients keep sending food to say thank you. That spirit should not end here.”
“The atmosphere is sad,” adds Santos, noting how close the staff had grown to their patients. Families often brought food to express their appreciation and sympathy, treating nurses like family—making the closure even more painful.
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The digital mammogram machine now turned off and ready for its next owner. Photograph by Jilson Tiu.
“The well has dried up. I can’t go on. I was sacrificing my marriage, my wife, myself—and I’m too old to keep pushing when there’s no end in sight,” says Dr. San Agustin. “I went to the government, I reached out to people, even sought help from psychiatrists and psychologists to cope, but still there was no solution.
“Yes, there are a few people still trying to help, but even if salaries are paid, there are no patients. So now, the Asian Breast Center will have to face reality and settle its debts with investors and others involved.” Asked if a lifeline has been offered, he says, “Well, one of them is in government—I can’t give names. They’re trying to work with very important people, but so far, it’s the usual political talk. Still, I keep praying.”
“Yes, there are a few people still trying to help, but even if salaries are paid, there are no patients. So now, the Asian Breast Center will have to face reality and settle its debts with investors and others involved.” Asked if a lifeline has been offered, he says, “Well, one of them is in government—I can’t give names. They’re trying to work with very important people, but so far, it’s the usual political talk. Still, I keep praying.”
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Dr. Norman with the ABC staff. "He treats nurses like family, and grateful patients keep sending food to say thank you." Photograph by Jilson Tiu.
His vision of making breast cancer care accessible to the poor while keeping ABC sustainable was almost within reach. The city leadership at the time was open to a public-private partnership with a government hospital, but that chance vanished with the change in administration. Under the next mayor, ABC managed to hold three days of Thermalytix screening. Yet, City Hall, says San Agustin, never even bothered to learn their name. If breast cancer is to be fought as a public health priority, leaders can no longer afford this indifference, he says. The advocacy must live on, with government and private partners working hand in hand to save lives.
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For Dr. Norman, the future of breast cancer care in the Philippines rests on one truth: early detection saves both lives and money. Photograph by Jilson Tiu.
After ABC, the oncologist plans to continue his work at his second home, Saint Nicole Farmstead, named after his only child who died in a skiing accident. Located in Alfonso, Cavite, the farmstead is envisioned as both retreat and place of healing, with casitas for visitors, a small healthcare facility, and spaces for prayer. At its heart stands a “mini cathedral” with two chapels—one honoring the Blessed Mother with the Holy Child in her womb, and a larger one devoted to St. Joseph, patron saint of the dying—together symbolizing care from womb to tomb.
For Dr. San Agustin, the future of breast cancer care in the Philippines rests on one truth: early detection saves both lives and money. Early-stage treatment costs far less, while advanced cases can drain families of millions. What he hopes for now is twofold: greater awareness among women for regular screening, and a government that makes public health a priority. For him, that means PhilHealth must finally recognize ambulatory surgical centers and include them in its “A” and “Z” packages—so quality care can reach every Filipino, not just the few who can afford it.
For Dr. San Agustin, the future of breast cancer care in the Philippines rests on one truth: early detection saves both lives and money. Early-stage treatment costs far less, while advanced cases can drain families of millions. What he hopes for now is twofold: greater awareness among women for regular screening, and a government that makes public health a priority. For him, that means PhilHealth must finally recognize ambulatory surgical centers and include them in its “A” and “Z” packages—so quality care can reach every Filipino, not just the few who can afford it.
Photographs by Jilson Tiu
Marge Enriquez has been writing about lifestyle and the arts for nearly four decades, with a special love for dance and cultural stories. On the side, she leads short Raja Yoga meditation retreats and occasionally creates and performs dance videos that blend movement with reflection.
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