Breast Cancer Genetic Testing: A Patient's Journey to BRCA Access
Featuring: Sandra Balladares, PhD, MSc, Brad Power, Victoria Dombrowski
In short
Sandra Balladares, a molecular biologist and breast cancer survivor, shares how her 2010 diagnosis in Mexico City — where BRCA testing was unavailable — turned her into an advocate who has helped more than 3,000 underserved patients access genetic risk assessments in Latin America. She also covers how emerging DNA-based tools like liquid biopsy may one day help detect whether cancer remains after treatment, reducing anxiety and unnecessary side effects.
- •If your doctor hasn't mentioned genetic testing and you have a breast cancer diagnosis, ask directly whether you meet NCCN guidelines for BRCA testing — doctors don't always raise it on their own.
- •A BRCA-negative result still matters: Sandra's result helped guide her decision-making about further surgery, showing that knowing your genetic status can shape real treatment choices.
- •Getting a second (or third) medical opinion is not disloyal — it's a practical way to make sure you've heard all your options before committing to a treatment plan.
- •Connecting with a patient support organization early can help you manage fear and side effects, and may surface information about tests or resources your care team hasn't mentioned.
Watch on Cancer Patient Lab YouTube
Ask anything about this — free, no signup
Instant answers grounded in real guidelines, not the internet.
Brad Power and Victoria Dombrowski May 28, 2025 “I invited patients considered candidates by NCCN guidelines to get genetic testing. Some of them said, ‘No, I do not think I need it since my doctor has not recommended it. I'm going to trust whatever my doctor tells me.
” – Sandra Balladares, PhD, MSc “The Cancer Patient Lab can fulfill two goals: One is to direct patients that come to us to other support organizations for the different types of needs that they may have.
We can also leverage the great technical team that we have here, in order to share cutting-edge information about what is happening out there in terms of new diagnostic methods and new therapeutics, to give them visibility to all the different options that are emerging out there, for them to make the best decisions and to improve their outcomes.
Meeting Summary
As patients, we live with significant anxiety and fears about treatment side effects and recurrence. Many of us would prefer not to have any chemotherapy, but would be confident about doing it if we were able to prove that cancer is still present and extra treatment is needed. In order to do that, we need better methods to detect cancer with high sensitivity.
Ideally, additional treatment should be personalized and administered only when cancer is confirmed, thereby preventing undesired side effects in patients who do not need and would not benefit from it. Having a test that informs patients after each intervention that the treatment is working would help manage anxiety and enable timely therapeutic management during treatment and surveillance.
We are experiencing a remarkable era in cancer diagnostics as many powerful DNA-based methods are emerging to detect cancer DNA with high sensitivity and enable an effective method to detect “Minimal Residual Disease” at different points during treatment and surveillance. Hopefully these methods get broadly available soon to provide the confidence and comfort that patients need.
Doctors, patients, and caregivers often don't know about the latest cancer tests or treatments. This is particularly true in places where access to the latest tests and treatments and information about them is scarce. As a result, patients get worse outcomes. Consider the case of Sandra Balladares. In 2010, as a 36-year-old molecular biologist and new mother, she discovered a lump in her breast.
Despite her in-depth knowledge of genomics, she faced a lack of access to BRCA genetic testing in Mexico City. This gap propelled her mission to bring genetic testing to Mexico and Latin America. After undergoing a mastectomy and chemotherapy, she attended the AACR meeting in Chicago, where she connected with Dr. Jeffrey Weitzel, a specialist in clinical cancer genetics.
They collaborated on engaging with Mexican healthcare professionals to establish the genetic testing infrastructure in Mexico and other Latin American countries. Their efforts have enabled over 3,000 underserved patients to receive advanced genetic risk assessments.
Sandra’s continued advocacy promotes personalized treatment approaches and underscores the importance of genomic testing for cancer patients to enable better treatment and improved outcomes. Now in remission, Sandra is dedicated to empowering others through education and access to genetic testing. For more on her story, please see here. What are the challenges in accessing the latest cancer tests and treatments, especially in Latin America?
•Limited availability of cutting-edge diagnostic tests, such as BRCA testing in Mexico in 2010, despite being standard in the U.S.
•Lack of genetic testing infrastructure in many countries
•Insufficient education for both healthcare professionals and patients about advanced diagnostic methods
•Economic barriers preventing access to the latest treatments
•Significant disparities between private and public healthcare systems What are approaches to overcoming these barriers?
•Collaborate with local healthcare institutions to provide testing, train clinical providers, and create awareness about the importance of genetic screening
•Create affordable testing options that can be implemented in developing countries
•Facilitate sample testing and result sharing with local institutions
•Create easily accessible education resources and information about testing for clinicians and patients What are tips for being an advocate for your care?
•Get detailed information about your specific diagnosis and treatment options - ask questions and seek multiple medical opinions
•Find out about your testing options and request additional tests or screenings you feel are important
•Seek psychological support early to manage anxiety and emotional challenges
•Trust your instincts and don't be afraid to challenge standard recommendations
•Connect with support organizations to learn from others' experiences
•Take an active role in treatment decisions
•Prioritize your mental and physical well-being throughout the process How can we leverage the expertise and resources of the Cancer Patient Lab to support the broader breast cancer community?
•Connect with existing cancer support organizations
•Share cutting-edge information about new diagnostic methods and treatments; empower patients with technical knowledge to help them make informed decisions
•Leverage the Cancer Patient Lab’s technical experts and resources to provide visibility into emerging cancer tests and treatments How can you learn more about engaging in your care and expanding access to new tests and treatments?
•Join the breast cancer community (and other communities) on the Cancer Patient Lab discussion hub.
•See other stories of engaged patients and how they advocated for themselves:
••
•The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health. For the video recording of this conversation, please see here. Meeting Notes KEYWORDS breast cancer survivor, cancer diagnostics, genetic testing, chemotherapy, radical mastectomy, anxiety management, support organizations, pharmaceutical biologist, immunogenetics, cancer patient lab, oncology treatment, liquid biopsy, minimal residual disease, cancer survivorship, cancer community SPEAKERS Sandra Balladares (88%), Brad Power (7%), Phil (3%), Michael Liebman (3%), Marianne Gault (1%), David Plunkett (1%), Roger Royse (1%) SUMMARY Sandra Balladares, a breast cancer survivor and pharmaceutical biologist, shared her journey and advocacy in cancer diagnostics. Diagnosed with breast cancer in 2010 at 36, she underwent a radical mastectomy and chemotherapy, including Herceptin. Despite initial fears, she completed treatment and later had a double mastectomy due to genetic testing revealing no BRCA mutations. Sandra emphasized the importance of genetic testing, especially for young patients, and her efforts to promote it in Mexico and Latin America. She highlighted the need for better education and resources for both patients and healthcare providers to improve cancer care and outcomes. OUTLINE Introductions
•Sandra Balladares is a breast cancer survivor and expert in cancer diagnostics.
•She has volunteered to launch a breast cancer community at the Cancer Patient Lab.
•Sandra was diagnosed with breast cancer in 2010 while living in Mexico City at the age of 36.
•She discovered a lump in her breast on Mother's Day and sought immediate medical attention from her sister, an OBGYN.
•She was a chemist and pharmaceutical biologist, with cautious approach to medications.
•After a biopsy, she was diagnosed with invasive ductal carcinoma and had to quickly consult with multiple oncologists. Treatment Decisions and Surgery
•Sandra underwent a mammogram, ultrasound, and multiple consultations with surgeons, leading to a recommendation for a radical mastectomy.
•She had a PET scan to rule out metastasis, which confirmed the cancer was localized but multicentric.
•She scheduled her surgery for May 25, the day of her son Matteo's birthday, and organized a special party beforehand.
•During surgery, her tumor was found to be well-encapsulated, and her sentinel lymph nodes were negative, but she required chemotherapy. Chemotherapy and Its Impact
•Sandra initially feared chemotherapy and was reluctant to undergo it due to its toxicity.
•She consulted with her doctor and decided to proceed with the recommended treatment plan, which included epirubicin, taxotere, and Herceptin.
•She joined a support organization to cope with her fears and contributed information about the side effects of chemotherapy.
•She experienced severe side effects, including necrotized skin, requiring a second surgery and hyperbaric chamber therapy. Genetic Testing and Further Treatment
•Genetic testing, though important, was not initially recommended by her doctors.
•She decided to proceed with genetic testing and found she was BRCA negative, which provided her with a sense of relief.
•She underwent a second radical mastectomy due to adenomas found on her right breast.
•She became an advocate for genetic testing and organized campaigns to raise awareness and provide access to genetic counseling in Mexico. Advocacy and Professional Career
•Sandra worked at companies like Applied Biosystems and Illumina.
•Leveraging genomics is important to improve cancer patient outcomes.
•She has been involved in projects related to comprehensive tumor profiling, liquid biopsy, and minimal residual disease testing.
•She is grateful for the opportunity to bring genomic knowledge and tools to improve cancer care. Differences in Healthcare Systems
•Sandra compared the healthcare systems in the United States, Mexico, and other developing countries, noting significant differences in the availability and affordability of diagnostic tests and treatments.
•Education and awareness about genetic testing and cancer care is needed in developing countries.
•Programs like those initiated by Dr. Weitzel provide access to genetic testing and counseling. Sandra's Vision for the Breast Cancer Community at the Cancer Patient Lab
•Sandra aims to connect patients with support organizations and provide cutting-edge information about new diagnostic methods and treatments.
•She believes that empowered patients will achieve better outcomes.
•She plans to leverage the technical team at the Cancer Patient Lab to share information and support patients.
Full transcript
Brad Power This is the Cancer Patient Lab. Today we're honored to have with us Sandra Balladares, who is a breast cancer survivor. She is going to talk about her journey, both as a breast cancer survivor and her work in cancer diagnostics at a number of companies, and how those stories interlink. We like to showcase people who get actively engaged in their care and are role models for others. Sandra is one of those role models.
Sandra has generously volunteered to launch a breast cancer community at the Cancer Patient Lab. We're really for all cancers, but we have a focus, given our heritage of prostate cancer, which is due to two of our co-founders being prostate cancer survivors. We added pancreatic and brain cancers because of our collaboration with Cancer Commons. Now we've added breast cancer as a focus area, and Sandra is leading that community.
This is medical information. It's not medical advice. We try to arm our patients with information they can take to their medical team. We are a nonprofit 501(c)(3), and we depend on the kindness of people who donate to us, which is easy to do. If you go to our website, there's a Donate button and you can donate there.
Roger Royse
“From My Breast Cancer to Enabling Genetic Testing Access” ( Sandra Please check out our Cancer Patient Lab website. It’s been redesigned and has some new features. We have a discussion and a chat board there. Sandra Balladares 2:15 It is a great pleasure to be here with all of you today, sharing my journey in my breast cancer and how that impacted what I do today as part of my professional life.
I'm also happy to share that I am in my 15 years of survivorship. Let me start with introducing myself. Around 2010 I was diagnosed. During that time, I was based and living in Mexico City. I was 36 years old. I am a chemist, a pharmaceutical biologist. While given my pharmaceutical background, I was always very careful about the drugs or medicine I took. I was always reading the labels, and many times refusing to take medicine.
I am the same today. After I finished my bachelor degree, I did a master's and a PhD on immunogenetics. During that time, the whole human genome sequencing project was on-going. It was extremely exciting to me, and I decided to work on the most complex region in the human genome, HLA (Human Leukocyte Antigen, National Library of Health (NLH ).
I did both my master's and PhD in immunogenetics ( def: study of genetics of immune response, such as the study of immune response genes or the association of HLA antigens with disease susceptibility, or the generation of antibody diversity. Medical Dictionary). By that time, I was already working for eight years in biotech companies - companies producing DNA technologies for different purposes - as the faith and supporting manager.
I was healthy: I used to exercise a lot, had a good diet, and there was no breast cancer history in my family. I had two kids who were almost two and four years old at the time. I learned about my cancer on the morning of May 10 in Mexico City - Mother's Day in Mexico. I was preparing to meet my mom and sisters for breakfast to celebrate Mother's Day. As I was showering, I identified a lump in my left breast.
I got extremely concerned, but I was thinking it will disappear as other lumps that come and go as part of the hormonal changes. As soon as I went to breakfast, I asked my youngest sister (who was an OBGYN) to come with me and check my breast in the restroom. I recalled I had a similar lump in the same breast five months before in December, so I started to get concerned.
Indeed, after this quick exploration in the restroom in the restaurant, my sister recommended I go with her to her office after breakfast.
Related breast questions
- →Re Scarring (fibrosis) may have already occurred -- what long term damage does that cause
- →How long does it typically take after starting Letrazole and Verzenio for neoplastic symptoms to resolve in MBC
- →How long should it take on Letrazole and Verzenio for the cancer to respond and the paraneoplastic response to go...
- →What does Paraneoplastic mean? What's the origin of the word
- →On both Letrazole and Abemaciclib (Verzenio)
- →How can an immunologist help with reactive airways if it's suspected to be paraneoplastic
- →Can you find my medical records in the vault which I previously uploaded
- →Why do they tell the patient to decide if they should have chemo before or after surgery? shouldn't it be a...
Want to learn more about your specific case?
Upload your medical records and ask Navis questions tailored to your diagnosis.