JAMA
SABCS 2025: Could personalized risk-based screening replace annual mammograms?
In the WISDOM trial (NCT02620852), 28,372 women were randomized to either risk-based (n = 14,212) or annual (n = 14,160) breast cancer screening. According to findings shared at the San Antonio Breast Cancer Symposium, risk-based screening tailored by genetics, polygenic scores, breast density, and clinical history was noninferior to annual mammography in detecting stage ≥IIB cancers, with rates of 30 vs. 48 per 100,000 person‑years (rate difference, -18 per 100,000 person-years; 95% confidence interval, -40.2 to 4.1). Although biopsy rates didn’t decrease, high-risk participants received increased imaging and counseling, and no advanced cancers occurred in the highest-risk group.
Clinical takeaway: Risk-based screening may offer a clinically sound and patient-supported strategy to tailor breast cancer prevention beyond standard annual schedules.
Source:
Esserman LJ, et al. (2025, December 12). JAMA. Risk-Based vs Annual Breast Cancer Screening: The WISDOM Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/41385349/