The Next Era of Breast Cancer Care: Genomic Testing, Advanced Radiotherapy and Integrative Oncology

Breast Cancer care is entering an increasingly personalised era, with genomic testing, shorter and more targeted radiotherapy, earlier diagnosis and integrative oncology emerging as important areas of progress, according to Penny Kechagioglou, Senior Consultant Clinical Oncologist and Chief Clinical Information Officer at University Hospitals Coventry and Warwickshire and Chief Medical Officer at Icon Group.

Breast Cancer Treatment Is Evolving Rapidly

Breast cancer treatment has changed considerably over the past two decades, driven by advances in cancer biology, drug development, radiotherapy technology and personalised medicine.

Speaking to EMJ Oncology, Kechagioglou described breast cancer as an evolving field in which new chemotherapy and radio-isotopic treatments continue to influence clinical practice, while technological advances are changing how radiotherapy is delivered.

She also highlighted the importance of prevention, early diagnosis, genomic and genetic testing, and improving access to cancer treatments and patient-centred care.

Why Earlier Diagnosis and Prevention Matter

Breast cancer can affect women and, less commonly, men. Kechagioglou emphasised the importance of recognising changing patterns of diagnosis and ensuring that patients can access appropriate investigation and treatment.

For modern breast cancer care, the goal extends beyond treating an established tumour. Prevention, timely diagnosis and understanding the biological characteristics of an individual cancer can help clinicians make more informed decisions throughout the patient’s treatment journey.

Genomic Testing Is Transforming Personalised Cancer Treatment

Genomic testing has become an increasingly important component of precision oncology. According to Kechagioglou, clinicians can now analyse genetic changes associated with cancer and use the information to help determine appropriate treatment strategies.

In some settings, genomic information can be obtained through blood-based testing, while other genomic analyses require tumour tissue. The resulting information can help clinicians understand the biological characteristics of a cancer and identify patients who may benefit from specific therapies.

Genomic testing can also help with treatment selection. Kechagioglou highlighted its role in distinguishing patients who are more likely to benefit from chemotherapy from those who may be able to avoid unnecessary treatment.

This approach is particularly relevant to precision medicine, where treatment decisions are increasingly guided by the characteristics of an individual’s tumour rather than relying solely on broad disease categories.

Radiotherapy Is Becoming Shorter and More Precise

Advances in breast cancer radiotherapy have also changed the patient experience. Kechagioglou noted that treatment courses for many patients have been shortened substantially, with some regimens moving from approximately five weeks to five days while maintaining comparable outcomes in appropriately selected patients.

Shorter treatment schedules can reduce the number of hospital visits and may make cancer treatment more convenient for patients, particularly those who need to travel for daily radiotherapy.

Deep Inspiration Breath-Hold Helps Protect the Heart

Techniques such as deep inspiration breath-hold (DIBH) have been developed to reduce radiation exposure to nearby healthy tissues during breast radiotherapy.

During DIBH, patients take and hold a deep breath while radiation is delivered. The resulting anatomical changes can increase the separation between the heart and the treatment area in appropriate patients, helping clinicians reduce cardiac exposure.

Volumetric-modulated arc therapy (VMAT) is another advanced radiotherapy technique that can help shape and modulate radiation delivery more precisely around treatment targets while limiting exposure to surrounding normal tissues.

Stereotactic Radiotherapy for Metastatic Disease

Kechagioglou also highlighted stereotactic radiotherapy, which allows high doses of radiation to be delivered with considerable precision to selected small areas of metastatic disease.

For appropriately selected patients, treating limited metastatic sites with highly focused radiotherapy can form part of a broader strategy for controlling advanced cancer. The suitability of this approach depends on factors including the number, size and location of metastases, the patient’s overall clinical situation and the biology of the cancer.

Integrative Oncology: Beyond Conventional Cancer Treatment

Another area of focus for Kechagioglou is integrative oncology (IO), which aims to combine evidence-based supportive approaches with conventional cancer treatment.

Lifestyle factors can influence cancer risk, and maintaining healthy behaviours is an important component of cancer prevention. Kechagioglou also pointed to research examining exercise, nutrition and psychological support alongside treatments such as chemotherapy, immunotherapy and radiotherapy.

These approaches should be viewed as complementary to evidence-based cancer treatment rather than replacements for established oncology therapies.

Exercise, Nutrition and Mental Wellbeing During Cancer Care

Exercise programmes can help some patients maintain physical function and manage treatment-related fatigue. Nutritional support can help address dietary needs during treatment, while psychological and emotional support can assist patients in dealing with the challenges associated with a cancer diagnosis.

The role of these interventions can vary according to the individual, cancer type, treatment and overall health. Integrative oncology therefore requires a personalised approach, ideally delivered as part of a multidisciplinary cancer-care team.

Leading Multidisciplinary Cancer Care

Breast cancer treatment increasingly involves collaboration between specialists from multiple disciplines, including medical oncology, clinical oncology, surgery, radiology, pathology, genetics, nursing, rehabilitation and supportive care.

Kechagioglou said this multidisciplinary environment is one of the aspects of breast cancer medicine that continues to motivate her after more than two decades in the field.

Her career has also included leadership across the public, private and charitable sectors, with a particular focus on healthcare innovation, digital health and clinical leadership.

The Role of the National Centre for Integrative Oncology

As Chair of the National Centre for Integrative Oncology (NCIO), Kechagioglou is involved in advancing the discussion around evidence-based integrative approaches to cancer care.

The broader objective of integrative oncology is to ensure that supportive interventions such as exercise, nutrition and psychological care are considered alongside conventional treatment when appropriate, while maintaining scientific evidence and patient safety as central principles.

What the Future of Breast Cancer Care Could Look Like

The direction of breast cancer care is increasingly shaped by personalisation. Genomic information can help guide treatment decisions, while modern radiotherapy can deliver treatment more efficiently and precisely. At the same time, prevention, early diagnosis and supportive care remain essential parts of the wider cancer pathway.

The combination of precision medicine, advanced radiotherapy, multidisciplinary working and evidence-based supportive care could provide patients with increasingly individualised treatment strategies.

However, access remains an important consideration. Advances in cancer technology and personalised treatment can only improve outcomes at a population level if patients can access appropriate testing, specialist expertise, treatments and supportive services.

Key Takeaways

• Genomic testing: Can help identify molecular characteristics of cancer and inform personalised treatment decisions.
• Shorter radiotherapy: Modern treatment schedules can substantially reduce the number of treatment visits for appropriately selected patients.
• Heart protection: Techniques such as deep inspiration breath-hold can reduce radiation exposure to nearby normal tissues, including the heart.
• Advanced radiotherapy: VMAT and stereotactic techniques allow radiation to be delivered with greater precision in selected clinical situations.
• Integrative oncology: Exercise, nutrition and psychological support can complement conventional cancer treatment when supported by appropriate evidence.
• Multidisciplinary care: Breast cancer treatment increasingly relies on collaboration between multiple clinical and supportive-care specialties.

Conclusion

The next era of breast cancer care is likely to be defined by increasingly personalised treatment, better use of genomic information, more precise radiotherapy and greater integration of supportive care. As Kechagioglou’s experience illustrates, technological innovation and multidisciplinary collaboration are becoming increasingly interconnected in modern oncology.

At the same time, ensuring equitable access to advanced diagnostics, treatments and supportive services will remain essential if these developments are to translate into better outcomes and experiences for patients.

Source: Interview with Penny Kechagioglou, Senior Consultant Clinical Oncologist and Chief Clinical Information Officer at University Hospitals Coventry and Warwickshire and Chief Medical Officer at Icon Group, published by EMJ Oncology, September 30, 2026.

Primary keyword: breast cancer care

Secondary keywords: breast cancer treatment, genomic testing in breast cancer, precision oncology, advanced radiotherapy, deep inspiration breath-hold, volumetric-modulated arc therapy, stereotactic radiotherapy, integrative oncology, women’s cancer care

Meta title: The Next Era of Breast Cancer Care: Genomics & Radiotherapy

Meta description: Breast cancer care is evolving through genomic testing, precision radiotherapy and integrative oncology. Expert Penny Kechagioglou discusses the future of treatment.

Disclaimer: This article is intended for healthcare professionals and is based on the cited EMJ interview. It does not replace official clinical guidelines, individualised medical assessment or professional clinical judgement.