Dec 13, 2025
3 min read
Researchers emphasize the approach to mammograms.
A rate of distance indicating that you observe disease for disease with older mammograms.
In a study published in JAMA and presented at the San Antonio Breast Cancer Symposium, Dr. Laura Esserman, a breast cancer surgeon and director of the Breast Care Center at the University of California, San Francisco, showed that more personalized screening schedules based on a woman's risk of developing the disease can be just as effective in detecting cancer.
In 2016, Esserman launched the WISDOM (Women Informed About Screening-Based Risk Measures) study to investigate whether a more personalized assessment of women's breast cancer risk could lead to alternative screening schedules that would work better than uniform annual mammograms.The first results, which included more than 28,000 women between the ages of 40 and 74, show that different screening regimens for high- and low-risk women are as good as current annual screenings.
The women, none of whom had breast cancer, were randomly assigned to either more individualized risk-based screening or annual screening.They were followed for an average of about five years to see if they developed the disease.In this first analysis, Esserman and her team found that alternative screening regimens, including more frequent or less frequent screening, were similar to annual breast cancer screening.This suggests that the alternative screening schedules did not prevent cancer.released
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The number of stage 2B breast cancers – the stage at which breast cancer deaths increase sharply, by three to eight times – was lower in the in-person screening group than in those who received annual screening."There's been a one-third reduction in the number of stage 2B cancers; that's remarkable," Esserman says.“Even I am surprised by these results.”
WISDOM also showed that changing the screening schedule did not harm women by missing cancer."This research is a prerequisite for implementing a risk-based approach," says Esserman."The first thing we had to do was show it was safe."
Dyuniba has long been concerned about the uniform breast cancer screening guidelines.He and other experts have long known that women vary widely in their risk of the disease, and as researchers have learned more about risk factors, they have found that certain variables are associated with higher risk.Studies have also shown that not all women with cervical cancer have a family history of the disease, which is a risk.Of the risk factors that doctors consider.
WISDOM's risk-based strategy involved genetic testing of nine breast cancer genes.Some of them alone have no significant effect on breast cancer risk, but combined studies link them to a higher risk.Other factors such as breast density, age, and medical history of the woman and her family were also included.Based on these risks, Esserman's team developed an algorithm to assign women to one of four different screening regimens.All women received risk factor counseling, and women at highest risk had mammograms and MRIs every six months.Women at increased risk received an annual mammogram;women at intermediate risk were scheduled for mammograms every other year, and women at the lowest risk did not receive a mammogram unless their risk scores changed.
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A personalized risk-based assessment provides more targeted screening that can benefit women, Esserman says.While the current study was designed to demonstrate its safety, she plans to monitor the treatment and outcomes."We are working to improve our risk reduction and risk prediction tools so we can improve our [breast cancer] prevention efforts," she says.Current screening methods are too broad and do not distinguish between high-risk and low-risk women, leading to overtreatment of some and missed cancers in others."We want to find the people who have the highest risk of cancer," he says.
The key to the use of risk-based screening is a robust algorithm that incorporates the latest knowledge about the main risk factors for the disease, which requires revising long-held views.The findings also argue for routine genetic testing of women starting at a relatively early age, Esserman says, because many of the highest-risk breast cancers appear when women are in their 30s or older.In the study, for example, 30% of women with high-risk genes had no family history of breast cancer."This surprised everyone, including us. It shows that family history is not a reliable way to determine who should undergo genetic testing," says Esserman.
The researchers also found women's expectations and options for breast cancer screening have evolved.The news has happened during the pandemic, which has changed people's tolerance of photos for the screen.
The WISDOM findings support other breast cancer studies investigating whether aggressive treatments are needed for very early, low-grade cancers like DCIS. Earlier this year, the COMET study, led by Dr. Shelley Hwang of Duke University, found that for some women diagnosed with DCIS, close monitoring with more frequent mammograms did not lead to a higher risk of developing breast cancer compared to those who chose to undergo surgery and radiation to remove the lesions.
The current findings are just the beginning of a great idea, women have been included in the following stages and screening can help cancer. "I would like to see these countries using the Essem screening program, including the UK, France and the Netherlands, rely on different versions of this approach."It is very interesting to have these results. Astronomy is more than good;
