WISDOM Study

WISDOM 1.0 Study Results: Personalized Breast Cancer Screening is Safe and Smarter

Steffanie Goodman — Sat, 13 Dec 2025 00:05:05 +0000

A Milestone Moment: WISDOM 1.0 Results Point to a New Future for Breast Cancer Screening

This year marks a major milestone for the WISDOM Study—and one made possible by the incredible commitment of our community. The long-awaited results from WISDOM 1.0 were published online December 12, 2025, in the Journal of the American Medical Association and presented at the San Antonio Breast Cancer Symposium, the world’s largest conference dedicated solely to breast cancer research. Together, these achievements signal an exciting step forward in how breast cancer screening and prevention may be approached in the future.

WISDOM launched in 2016 with a bold goal: to determine whether screening tailored to a woman’s individual risk could be as safe—and potentially more effective—than the one-size-fits-all approach based mostly on age. The results are in, and they are encouraging.

What We Learned

WISDOM 1.0 enrolled more than 46,000 women between 2016 and 2023. Over 28,000 participants agreed to randomization, with half assigned to annual mammography and half to a personalized, risk-based screening schedule. The central question was straightforward: could tailoring screening intensity to personal risk be as safe as annual screening?

The answer was yes. Matching screening to individual risk did not increase the rate of advanced cancers. In fact, nearly 90% of participants chose risk-based screening when given the option, signaling a strong preference for an approach grounded in personal health information rather than a calendar date.

How Personalized Screening Worked

Participants in the personalized arm completed a detailed questionnaire using the well-validated Breast Cancer Surveillance Consortium (BCSC) risk calculator. Risk assessment also incorporated genetic testing through Color Health’s Hereditary Cancer Panel, polygenic risk scores, breast density, and other biological and lifestyle factors.

Based on this information, women were grouped into four risk categories and matched with screening recommendations aligned to their needs:

26% were low risk and advised to delay screening until age 50, or earlier if their risk reached that of an average 50-year-old

62% were average risk and recommended screening every two years

8% were elevated risk and recommended annual screening

2% were high risk and recommended screening twice per year, alternating mammography and MRI

Among women in the highest-risk group, no stage 2B or higher cancers were detected—an especially promising finding that highlights the potential of targeted, intensive screening for those who need it most.

Why WISDOM Is Different

WISDOM is about more than screening intervals—it’s about empowering women with knowledge and options. Participants at elevated or high risk received personalized risk-reduction recommendations, including access to educational tools, consultations with breast health specialists, and guidance on lifestyle changes or medications.

The study also revealed how much risk can be missed under current guidelines. Thirty percent of women who tested positive for high-risk genetic variants had no reported family history of breast cancer and would not have been offered genetic testing otherwise. By looking beyond BRCA1 and BRCA2 and incorporating polygenic risk scores, WISDOM was able to refine risk estimates and reclassify 12–14% of participants into more accurate risk categories.

A Safe, Preferred, and Forward-Looking Approach

Importantly, personalized screening did not increase late-stage cancer diagnoses. The rate of stage 2B or higher cancers—the study’s primary safety outcome—was noninferior in the risk-based group compared with annual screening. While biopsy rates overall were similar between groups, diagnostic procedures were concentrated among women at higher risk, aligning care more closely with need.

Looking Ahead With Gratitude

WISDOM continues to evolve. WISDOM 2.0 began enrolling participants as young as age 30 with the goal of identifying women at higher risk for aggressive breast cancers earlier in life. By combining individualized screening with prevention strategies, we aim to support long-term health and help redefine how breast cancer is detected and prevented.

As we reflect on these results, we are deeply grateful to the tens of thousands of women who made this research possible. Your participation, engagement, and trust are helping to pave the way for a future in which breast cancer screening is more personal, more precise, and more empowering for everyone.

Access the Research Summary in JAMA.
Access the Full Text Article in JAMA; Published Online: December 12, 2025; doi: 10.1001/jama.2025.24784
Access the Full Text Article about our genetic test results in JAMA
Read about our genetic testing results in our blog article

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New WISDOM Study Findings Reveal Benefits of Broader Genetic Testing for Breast Cancer Risk

Steffanie Goodman — Wed, 10 Dec 2025 23:19:27 +0000

We are excited to share important new findings from within the WISDOM Study that could reshape the way we think about genetic testing for breast cancer risk. The full text article was published online here December 12, 2025 in JAMA Intern Med.

Analyses of WISDOM participant data from 2016-2023 showed that many women who do not qualify for genetic testing today may still carry important genetic changes linked to breast cancer. This research was led by one of WISDOM’s own investigators, Lisa Madlensky, PhD, a professor of medicine at UC San Diego School of Medicine and director of the Family Center Genetics Program at Moores Cancer Center at UC San Diego Health. Dr. Madlensky has long been a national leader in clinical genetics, and her work continues to expand our understanding of who stands to benefit from personalized breast cancer screening.

What We Found

Under today’s clinical guidelines, most women are only offered genetic testing if they have a strong family history of breast cancer or belong to certain ancestries known to have higher mutation rates. But our new findings suggest that this approach may leave many women unaware of important genetic risks.

In WISDOM, nearly 1 in 38 women carried a pathogenic mutation -a change in a gene that increases breast cancer risk. Importantly, we found that 30% of these women did not have any family history of breast, ovarian, or male breast cancer in their families. Given this fact, they would not normally be offered testing under current clinical guidelines, yet their results could have a real impact on their health decisions including screening and prevention.

Why This Matters

This discovery supports a key idea behind the WISDOM Study: every woman’s breast cancer risk is unique. Genetics, lifestyle, breast density, environment, and other factors all play a role. If many women with no obvious genetic risk factors (like family history of breast cancer) still carry important genetic information, then expanding access to testing may help identify women who can benefit from early, tailored interventions.

Dr. Madlensky’s leadership on this research underscores the value of including genetics into modern breast cancer screening and the importance of questioning the long-standing assumptions about risk.

How This Fits Into the WISDOM Study

The WISDOM Study is designed to test whether personalized screening—based on each woman’s individual risk—is as safe, more effective, and potentially less burdensome than the one-size-fits-all annual mammogram approach.

These new results highlight why a personalized approach matters. When we look at risk from multiple angles, including genetics, we may be able to better identify who needs more—or less—screening over time.

Our Partners in This Work

We’re also grateful for our collaboration with UC San Diego Health, home to Dr. Madlensky and the region’s only National Cancer Institute-designated Comprehensive Cancer Center. Their team provides state-of-the-art breast cancer care, including genetic testing, advanced imaging, surgery options, and access to clinical trials.

Moving Forward

These findings add powerful evidence to a growing body of work showing that risk-based screening has the potential to improve outcomes for many women. We’re proud to see one of our own investigators leading this conversation at the national level, and we’re grateful to every WISDOM participant whose contributions make discoveries like this possible.

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Women of WISDOM: Why One UC Leader Chose Personalized Breast Cancer Screening — and Why She Stays

Steffanie Goodman — Thu, 20 Nov 2025 01:08:51 +0000

An interview with Dr. Yvette Gullatt, WISDOM Participant & Vice President for Graduate and Undergraduate Affairs, Vice Provost for Equity, Diversity and Inclusion, and Chief Diversity Officer – University of California System

As Vice President for Graduate and Undergraduate Affairs and Vice Provost for Equity, Diversity, and Inclusion for the University of California system, Dr. Yvette Gullat spends her days focused on fairness, access, and opportunity. But when a colleague posted about the WISDOM Study on Facebook, the invitation struck her on a personal level.

Breast cancer was not something she had grown up fearing. There was no strong family history, no generational pattern. But she was acutely aware of a painful truth: Black women are more likely to die from breast cancer, often because of later-stage diagnoses, structural barriers, and inequities in screening and treatment.

“When I hear that a Black woman has breast cancer, there’s a different sinking feeling in my stomach about what the prognosis will be,” she shared. “I know it’s not universally true, but it feels different.”

So when she saw the post encouraging participation, she thought, Why not?

“What harm could be done?” she said. “And if I could learn something about myself in the process, even better.”

A First Encounter With Personalized Screening

She remembers the process clearly: the saliva sample, the follow-up, the personalized recommendation. Before joining WISDOM, she had been consistent about mammograms—especially after turning 50. Though her doctor told her she could now screen every two years, she chose to go annually.

“In my mind, I’m thinking Black women get breast cancer worse, so I’m going to do it every year.”

Her WISDOM screening recommendation aligned with national guidelines—every two years. But she still chooses yearly mammograms.

“Because I can,” she said simply.

Part of that choice comes from receiving consistent notices about her dense breast tissue. Another part comes from something deeper: an awareness of how medical racism shapes care, communication, and trust.

“When we think of medical racism, we think of neglect, people not being heard, babies dying, pain being dismissed. So even though I’m a researcher and I trust medicine in the abstract, I approach my own health differently. If they say something is the minimum, I’m going to do more.”

Why the Annual Questionnaires Matter

Surprisingly, one of her favorite parts of the study is the annual questionnaire.

“I actually find the questionnaires wonderful,” she said. “We don’t always think about our health holistically. The questionnaire prompts me to look at the behaviors that might affect breast cancer risk.”

She laughs when she admits: “I stand up straighter. I eat more vegetables. It’s a reminder—like someone is paying attention.”

The simple act of reflecting on her sleep, stress, and emotional well-being has helped her take better care of herself overall.

“What I’ve learned from this study is to take better care of myself generally. These kinds of things are good reminders.”

Why She Stays in the Study

Remaining in the WISDOM Study was an easy decision.

“It’s one of the easiest things I do,” she said. “I see no reason to step away.”

Beyond personal benefit, she sees her participation as a contribution to something larger—something urgently needed.

“There isn’t enough data in clinical studies on Black people. It impacts the care we get and how decisions are made. Participating in studies like WISDOM helps researchers understand our risks, our needs, and our outcomes.”

Her Message to Women—Especially Black Women—Considering WISDOM

Her advice is straightforward and powerful:

“Anything you can learn about your health is beneficial. You’re going to get screened anyway—so why not participate and make it better for yourself?”

But she also speaks directly to the broader impact:

“You’ll be helping the community of women—and Black women in particular—understand and manage their risks. There isn’t enough data on us. We change that by participating.”

For her, WISDOM is not just a study. It’s a tool for self-awareness, a resource for prevention, and a way to push for equity in the medical system—one woman, one saliva kit, one data point at a time.

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Women of WISDOM: A Life Transformed by Self-Advocacy, Faith, and the Power of Knowing Your Risk

Steffanie Goodman — Thu, 20 Nov 2025 00:53:24 +0000

An interview with Marion Harris, Community Health Nurse and Educator, WISDOM Study Advisor

Marion became a nurse at 18, long before she knew how profoundly her career—and her courage—would shape the lives of others. What pushed her toward nursing wasn’t a lifelong plan but a summer spent working in a sweltering glass factory in Tampa, Florida. “It only took me half the summer to realize I was not a lifetime factory worker,” she recalls. Her grandmother nudged her toward the field, recognizing her compassion and strength long before she recognized it in herself.

She enrolled in community college, earned her bachelor’s degree, and—decades later, in her 50s—returned for dual master’s degrees in nursing and education. “I loved nursing,” she said simply. Her passion for caring for others never wavered. But it was breast cancer—twice—that redirected her life’s purpose.

A Young Woman, Unheard

Marion’s path with breast cancer began unusually early. At 17, she had a lump removed with little explanation offered. At 28, she found another mass—and this time, she trusted her instincts. But getting her concerns taken seriously proved to be a battle.

For three years she pushed for a biopsy. “I just felt off-center,” she said. “I knew something wasn’t right.” Yet her doctor dismissed her concerns, calling her dramatic, telling her she was “too young” for a mammogram.

When he finally agreed to a biopsy—“so you can stop bugging me”—Marion woke up not in an outpatient clinic, but in a hospital bed. Seconds into consciousness, she knew what that meant.

Late that night the doctor confirmed it: breast cancer.

When she asked about her options, the surgeon recommended a modified radical mastectomy—because he had “good success with it”—and discouraged her request for a bilateral procedure. “There you go again being hysterical,” he said, insisting she shouldn’t have breast cancer at all based on her lifestyle.

She was given no time for a second opinion. Surgery was scheduled for the next morning.

“Even though I was a nurse, I had never seen a woman with breast cancer who wasn’t stage 4,” she said. “So I said okay—let’s get it done.”

Surviving, Then Fighting Forward

Marion’s mastectomy left her with a long vertical scar from armpit to chest wall—a reminder of an era when treatment decisions lacked sensitivity, options, and collaboration.

But she had children to raise and a life to restructure. “My breasts were the least of my concern,” she said. “I was fighting for my life.”

Information she needed didn’t come from her surgeon—it came from her colleagues, who quietly helped her access her pathology results. “I found out I didn’t have metastatic disease through my own network,” she said. “Not from my doctor.”

This was the moment Marion became the advocate she needed. “I was getting second opinions before anyone thought about second opinions.”

Years later, after moving to California, a new mass appeared only two months after a mammogram. Her oncologist listened, acted quickly, and confirmed recurrence. She underwent her second mastectomy and chemotherapy.

The Turning Point: Understanding Her Genetics

In her 50s, Marion began hearing about genetic testing. Again, she asked her doctor for it. Again, she was dismissed.

“He told me it wasn’t necessary.”

So she marched to her oncologist’s office. “Hey Peggy,” she told the nurse she trusted. “I hear there’s gene testing available. Can I talk to the doctor about it?”

This time, she was heard. Genetic testing revealed she carried a BRCA2 mutation—information that explained her early cancers and empowered her to advocate for the preventive surgeries she needed.

Her gynecologist insisted her uterus was “perfect” and unnecessary to remove, even with her mutation. But she persisted and ultimately underwent a hysterectomy and oophorectomy.

“He came to my bedside and said, ‘It’s a beautiful uterus,’” she recalls. Her response: “I’m glad to hear that. Give it to someone who needs it—because it’s death to me.”

From Patient to Advocate

Marion’s advocacy began almost immediately after her first cancer diagnosis. The American Cancer Society sent her a Reach to Recovery volunteer—an elderly white woman whose kind words couldn’t touch the unique fears of a 31-year-old Black single mother facing a life-altering diagnosis.

“I appreciated her,” she said, “but she couldn’t understand my life. I knew other women like me had to be out there.”

So Marion became a volunteer herself—then a leader, mentor, and force for change. She served in Reach to Recovery, Look Good Feel Better, chaired Relay for Life events, and led East Bay fundraising efforts. She trained more than 200 nurses as a faith community nurse, bringing culturally grounded health education to churches across the Bay Area.

“Breast cancer gave me my life,” she said. “It taught me what’s important—being present for my family, my community, and giving more than I take.”

Why Marion Believes in WISDOM

When Marion learned about the WISDOM Study, she recognized something she’d rarely experienced: women being offered information before disease, and being given a say in their care.

“I think it’s potentially lifesaving,” she said.

———————

Marions story is one of courage and self-advocacy. Many of the trials she went through were a product of poor communication within her hospitals, and policies that have since been improved through work by woman advocates such as Marion, and we thank her for her work and her priceless service.

Mastectomies have a long history of leaving woman feeling violated or unfit, but the process has been improved over decades of practice and research. Make sure to talk to your doctor about your expectations for the outcomes of a mastectomy or lumpectomy to ensure that you remain comfortable with your body.

If you feel like you are not receiving the proper care or communication from your doctor, self-advocate by talking to your hospitals social workers, by reaching out to breast cancer support and advocacy groups (link to https://www.cancer.org/treatment/support-programs-and-services.html), or by calling the 24/7 Cancer Support Hotline managed by the American Cancer Society at 1-800-227-2345.

We thank Marion for her participation in WISDOM, her bravery, and her willingness to share her story publicly. The Women of WISDOM are who make this study possible. We appreciate hearing stories about your experiences in WISDOM, learning what things have been meaningful and what may need improving. This is what helps drive us forward to continue with our mission, through the good times and the bad. If you would like to share your story and be featured in our Women of WISDOM blog series, please send an email to wisdomcommunity@ucsf.edu

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How One Woman Turned Curiosity into Empowerment Through the WISDOM Study

Steffanie Goodman — Mon, 17 Nov 2025 23:27:03 +0000

An interview with Alli Hobbs, WISDOM participant & champion

When an email from UCLA Health landed in her inbox, Alli Hobbs almost ignored it. But the subject line—breast cancer screening research opportunity—caught her eye. Lately, breast cancer awareness had been on her mind, thanks in part to public figure Katie Thurston, who had been remarkably open about her own recent breast cancer diagnosis. The timing was impactful.

“I’d been thinking more about my own health, so when I saw the WISDOM Study email, it felt like the perfect chance to be proactive and contribute to something bigger than myself.”

Alli’s family history of breast cancer included just one case—her grandmother, who had been treated for DCIS with a lumpectomy many years ago. It never felt like a major red flag. But hearing Katie talk about discovering a genetic mutation for breast cancer without any family history made her reconsider what she thought she knew about risk.

“Her story really made me want to learn more,” she said.

Joining the WISDOM Study, she discovered, was refreshingly simple: sign up, receive the kit, mail it back. Before Alli knew it, her results arrived—more quickly than she expected—and with them, a sense of reassurance and empowerment.

“It felt good knowing I was doing something both for myself and for research that could help other women, too.”

Inspired, she shared the study with her family. Then, on a whim, she sent Katie Thurston a DM with the link. She didn’t think much of it—Katie receives thousands of messages, after all. But one day, she opened her notifications to see the unlikely: Katie had seen it. And shared it. Many times.

What happened next amazed Alli. The Marketing lead from the WISDOM team reached out to tell her that Katie’s posts led to months of surges of new participants—thousands of young women who, like her, wanted to learn their risk for breast cancer, get support, and receive personalized guidance on breast cancer screening.

“I was blown away,” she said. “I never expected my little message to turn into something so meaningful.”

Today, Alli feels grateful—grateful to Katie for amplifying the message, grateful to the WISDOM community for making research accessible, and grateful for the chance to take charge of her own health in a new, informed way.

“It’s been a really special experience,” she said. “It’s inspired me to look for more opportunities to make a positive impact.”

For her, what began as curiosity became a powerful reminder: sometimes the smallest action—opening an email, sharing a link, speaking up—can spark something that reaches far beyond ourselves.

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A Familiar Feeling: Why I Joined the WISDOM Study

Steffanie Goodman — Mon, 17 Nov 2025 22:20:14 +0000

A personal essay by Dr. Nia Bailey, WISDOM Study Community Advisor & Participant
My DNA. A feeling that felt familiar. I couldn’t quite put my finger on it, but it was as if I had felt it before — a sense of déjà vu that I came to recognize as the feeling of cancer.
This realization wasn’t just physical — it was ancestral. My DNA had felt this before. Let me explain.
My Great Grandmother’s Strength
The presence of cancer was first felt by my great-grandmother, Marie Pryor, a 4’11” half Black and half Cherokee woman, born on May 10, 1910, in South Carolina.
Marie was married and birthed eleven children. She was a phenomenal cook, gardener, baker, wife, mother, friend, and child of God. Later in life, she was diagnosed with breast cancer.
Her experience mirrored that of her mother, grandmother, and ancestors — women who likely battled similar diseases that were unnamed or never spoken about.
Living in rural South Carolina during Jim Crow, Marie endured polluted well water, long hours of work, little rest, and the constant weight of caring for her family.
All of these factors may have contributed to her diagnosis, but her resilience was just as deeply rooted as her pain. That strength was woven into our family’s DNA, passed through generations.
The Legacy of Cancer in My Family
Of Marie’s eleven children, two are still living. The rest, including my grandmother, passed away from cancer:
Marie Pryor – Breast Cancer
Errol – Lung Cancer
Herman – Multiple Myeloma
Bobby – Breast Cancer
Cora – Breast Cancer
Chris – Unknown (suspected cancer)
Ann – Liver Cancer
Mattie – Pancreatic Cancer
Lorraine Byrd Fields Latham – Multiple Myeloma
Each name represents not just a diagnosis, but a story — of endurance, faith, and love.
A Legacy of Survival and Faith
Marie’s daughter, my grandmother Lorraine Byrd Fields Latham, was born on June 28, 1932, in Enoree, South Carolina. Like her mother, she too faced a cancer diagnosis — Multiple Myeloma.
She later migrated to Philadelphia to seek a better life for her family. Despite the hardships of segregation and limited opportunity, she carried a strand of resilience and deep faith. Lorraine birthed four children, was active in her community, and served as a devoted woman of God.
Her faith, strength, and perseverance became the foundation of our family’s legacy.
My Mother’s Story: Turning Pain into Power
Lorraine’s youngest child and only daughter — my mother — Narda J. Fields, was born on September 30, 1961, in Philadelphia, Pennsylvania. Though she has not had cancer herself, she carries the emotional and epigenetic imprint of her mother’s and grandmother’s battles.
Instead of allowing that weight to define her, my mother turned pain into purpose. She is now a two-time author, humanitarian, chef, and nonprofit leader — a radiant example of what faith and resilience can create.
My Own Experience: Feeling the Weight of History
My name is Nia Imani Bailey. I was born on August 26, 1992, at Temple University Hospital in Philadelphia.
I carry the stories and strength of the women before me — and, like them, I carry a genetic connection to cancer. I have a BCL6 gene mutation, which increases my risk for lymphoma.
My father, Curry J. Bailey III, was diagnosed with prostate cancer in 2008 and has been thriving ever since. My parents’ transparency about our family’s medical history has empowered me to live with awareness, not fear.
That’s why I joined the WISDOM Study — to take proactive steps for my health, to have informed conversations with my doctor, and to ensure that future generations in my family are better equipped and informed.
I was raised to believe that education is power, that faith fuels action, and that prevention is a form of love — for ourselves and for those who come after us.
Breaking the Cycle
My goal is simple: to stop passing on the genetic feeling and diagnosis of cancer.
I want to pass on resilience, faith, education, and wellness.
Leadership, especially in women, is built upon our ancestry. The women in our family were trailblazers — teaching us to stand tall, stay rooted in faith, and remain unshakably resilient.
What we experience today, our DNA has experienced before. But like our ancestors, we can rewrite the story — we can change the narrative, change our outcomes, and change our legacy.
So that our children — our girls — will remember our stories, but will not have to relive our pain.
We are, and will always be, our sisters’ keepers.
A Call to Action for Women
Be kind to ourselves and to each other
Support and uplift the next generation of women leaders
Continue the legacy of resilience and faith
Donate to WISDOM
Enroll in the WISDOM Study
Together, we can make a difference — for ourselves, for our families, and for the sisters who will come after us.
“It’s the rent we pay by living on this earth.”
With Agape Love,
Dr. Nia Imani Bailey

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From Family History to Personal Prevention: A Doctor’s Journey in WISDOM

Steffanie Goodman — Thu, 02 Oct 2025 22:04:59 +0000

We had the pleasure of speaking with Dr. Jennifer Swenson DO, the Senior Medical Director of Strategic Partner Operations at Optum and a WISDOM participant.

Dr. Swenson shared with us how breast cancer has impacted her life and her unique experience in the study.

Q: How did you learn about the WISDOM Study?

I was a Senior Medical Director with Optum WellMed when I attended the Partnership Forum in 2023. At the event, a team was there discussing WISDOM. I was in the audience listening and thinking it was perfect timing, as my sister and mother had both been diagnosed with breast cancer a couple of years prior. My sister was 48, and my mother was 76. My sister had genetic testing but tested negative for BRCA; my mother never had genetic testing. I figured there wasn’t a strong family link, so it was a great opportunity for me to participate in a study and learn if I should change my screening recommendations.

I forgot about the study until I ran into a colleague, who reminded me at a workshop. She described the process as very easy—sending a kit, providing a saliva sample—simple. I took out my phone and registered online; it was easy. Within two weeks, I received the results in the mail: the genes tested were negative. However, I then got a request for a consult with a WISDOM Breast Health Specialist. She walked me through the study, the tests done, and how a 5-year risk score was computed based on various factors, including the Polygenic Risk Score (PRS). I wasn’t familiar with PRS, but she did a great job explaining it to me. I didn’t tell her I was a doctor; I wanted to hear a basic explanation. With her explanation of my PRS, my adjusted risk was elevated leading to a recommendation for increased screening and risk-reducing medications.

I took time to think about it and decided to find a new doctor. I was concerned about having to explain everything to a physician, but I printed out the materials from your website, which was great. I discussed it with my doctor and decided to take a low dose of tamoxifen.

During this process, another sister was diagnosed with breast cancer as well, in her late 50s. We were all so surprised, as there was no prior history in the family. Everyone lives spread across the country, with different ages and lifestyles, so it was surprising and unexpected that we’ve had so many diagnoses in the recent few years.

I’m grateful for being able to participate in the study, learn about my risk, and understand what to do to lower it and take control of my health.

Q: What about wisdom has been the most meaningful to you?

Finding out results that really could impact my future, my life, having the knowledge of the increased risk early on. I am the youngest of five kids, so I feel like I have a huge advantage now that I was given this information early on and that I have the opportunity to take medication and change my approach to screening to reduce my risk, and be proactive in early identification if I were to be diagnosed with breast cancer, versus my sisters and my mom. I think they were doing their regular screening, and then they found out they had the diagnosis. Now I can benefit by hopefully preventing that diagnosis.

Q: Has being part of wisdom impacted your knowledge of breast cancer risk, and if so, in what ways?

Oh yeah, absolutely. I think one of the biggest learnings for me was learning about the SNPs and the polygenic risk score. That’s something I was not familiar with. I knew about some of the genetic mutations like the BRCA gene, but this was a different lens of information that I hadn’t been familiar with before. And so I think that was informative and definitely a new learning for me.

I assumed I was low risk for cancer. When my sister (who got diagnosed at 48) received test results that were negative for mutation on the BRCA genes I thought I was in the clear, and that my sister and mom’s cancers must’ve been unrelated. They were just freak things. But then I joined this study and in the interim of getting my WISDOM results, my other sister got diagnosed. I was like, oh, maybe there is something going on here. I just couldn’t tie it together. Everyone just seemed to be so different in their other risk factors like any lifestyle habits, weight, age that they got their first period, age they went through menopause, how many children they had – no one mirrored each other. I couldn’t think of a link. So, I assumed I don’t have to worry, I’m low risk. Right? So, I was very grateful to learn from WISDOM about my risk through my PRS.

Q: In what ways has being part of wisdom changed your perspective on the approach being taken to screen women?

I think that the screening guidelines for breast cancer are very confusing for the public because there are so many different guidelines, depending which ones you follow, when do you start, how often do you get mammograms. And I think different providers also probably recommend things according to what guidelines they’re following. When you really consider all of someone’s risk factors that are measured in this study, you get a much clearer picture of what is going to be the best screening plan. So you’re not doing too much, you’re not doing too little, but you’re getting the right surveillance based on your individual risk.

Q: What would you tell women who are on the fence about joining WISDOM?

I’d say I know sometimes people let fear guide their choices, and certainly people get nervous or fearful of what the results could show. But honestly, I think there is a bigger benefit of having the additional knowledge, the awareness and the ability to be proactive and say, I have other choices. I could take chemo prevention, or I could increase the frequency or type of screening that I get, it makes a world of difference. Knowledge is power. For me, being proactive and participating in this study has been life changing.

Acknowledgments

We are so grateful for Dr. Swenson, Dr. Ken Cohen, and Optum Health’s partnership to make WISDOM available to providers and patients in the Optum network.

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Optum Health offers a free Continuing Medical Education curriculum about the WISDOM Study and Precision Prevention. This course is open to the public (you do not need to be a provider in the Optum network to take this course).

This on-demand webcast provides a comprehensive overview of breast cancer screening, prevention strategies and treatment advancements.
Participants will explore the evolving landscape of breast cancer screening, including its contributions to reducing mortality rates, its current limitations, and the impact of advancements in breast cancer biology on screening and prevention practices.
Special focus is given to the objectives and implications of the WISDOM study, empowering participants to engage in generating new data to shape the future of breast cancer screening and prevention.

To learn more and register in this course please visit this link at Optum Health Education.

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Turning Insight into Action: An OBGYN’s Journey Through the WISDOM Study

Steffanie Goodman — Fri, 30 May 2025 21:17:37 +0000

An Interview with Dr. Heidi Arbona, OBGYN & WISDOM Study Participant

Interviewer: Can you tell me a little about yourself?

Dr. Heidi: Sure! I’m 53 years old and an OBGYN. Over the years, as both I and my patients have aged, I’ve developed a deep interest in perimenopause and menopause care. Surprisingly, I didn’t learn much about this in med school or residency, so I did a deep dive into menopausal medicine. I even attended the Menopause Society conference in Chicago last year. That’s where I first learned about the WISDOM Study.

Interviewer: How did you get involved with WISDOM?

Dr. Heidi: After learning about the study at the conference, I was intrigued. I contacted my office manager and asked her to feature it on my clinic’s website. Then I enrolled myself. I’ve referred many patients to WISDOM since then and have it prominently displayed on our homepage at Northside Women’s Health in Westerville, Ohio.

Interviewer: What was your experience like as a participant?

Dr. Heidi: It was eye-opening. I had been getting annual mammograms and ultrasounds due to my dense breast tissue, and everything had always been normal. Through WISDOM, I found out I had a CHEK2 mutation. A genetic counselor from the study reached out to me and spent nearly 30 minutes on the phone explaining everything clearly and compassionately. She reviewed my family history, walked me through the implications of the mutation, and emphasized the importance of breast density and lifestyle factors. She recommended that I meet with a genetic counselor in person and also consult with a breast surgeon.

Interviewer: What happened next?

Dr. Heidi: I followed through and met with a hospital-based genetic counselor, who offered me additional RNA testing. She explained that while it was unlikely to yield new information for my specific case, it could benefit family members by making future testing for them more accessible and affordable. That was something I hadn’t known as a physician. After that, I met with a breast surgeon, who recommended switching from automated breast ultrasound (ABUS) to an MRI due to my extremely dense breast tissue and genetic mutation.

Initially, the cost of a traditional MRI was daunting—about $1,700. But I learned our hospital offered a self-pay abbreviated breast MRI for around $300. My breast surgeon and even my husband, who is a radiologist specializing in mammography, agreed that this imaging was excellent for screening purposes. That imaging revealed abnormalities that required further investigation.

Interviewer: That must have been difficult to hear.

Dr. Heidi: It was, but I was able to get a biopsy quickly that revealed DCIS. My surgeon offered a lumpectomy with radiation or mastectomy, or bilateral mastectomy given the mutation, my extremely dense breast tissue, and the chance that I could someday develop abnormalities in the other breast. I ultimately chose to have a bilateral mastectomy with reconstruction and I’m grateful I did. My pathology report showed additional concerning areas in both breasts, including Grade 3 DCIS and multiple areas of atypical hyperplasia in my “normal’ breast. Unfortunately, I needed a second surgery to address a positive margin in my affected breast. My final pathology demonstrated negative margins.

Interviewer: How are you doing now?

Dr. Heidi: I’m recovering well. I’m four weeks out from my second surgery, cleared for exercise, and feeling more like myself. I’m grateful for how quickly everything moved once I was in the system—from testing to imaging to surgery. I truly believe that being part of WISDOM helped me catch this early and avoid more aggressive treatments.

Interviewer: Has WISDOM impacted how you talk to your patients about risk?

Dr. Heidi: Definitely. I already focused on breast density and lifestyle factors, but now I speak more about personalized risk. I refer many patients to the study. It’s accessible and offers meaningful information that can change lives.

Interviewer: What would you say to someone who is hesitant to join the study?

Dr. Heidi: I’d say, know yourself. If information empowers you, this study is incredibly valuable. It can help identify risks early and offer a roadmap for prevention. But if you’re someone who would feel overwhelmed by knowing you carry a mutation, consider how you’d manage that information. The process itself is quick, easy, and can have a major impact.

Interviewer: Do you have any feedback for improving the study?

Dr. Heidi: Just continue to raise awareness, like what you are doing now. More people should know about it. I’m happy to help spread the word in my community and among my colleagues.

Interviewer: Thank you so much for sharing your story, Dr. Heidi. We’re so grateful for your insights and support.

Dr. Heidi: Thank you. I’m thankful to be part of it and to contribute in any way I can.

We are grateful to Dr. Arbona for sharing her experience with our community, and her ongoing support of the study.

Do you have a story to share? Email us at wisdomcommunity@ucsf.edu!

The post Turning Insight into Action: An OBGYN’s Journey Through the WISDOM Study appeared first on WISDOM Study.

How AI is Revolutionizing Breast Cancer Screening: Deep Learning and Breast Density Prediction

Steffanie Goodman — Tue, 27 May 2025 19:31:17 +0000

Understanding the Role of Breast Density in Cancer Detection

Breast density is a risk factor for breast cancer that’s getting a lot of attention right now. Dense breast tissue not only makes it harder to detect tumors on a mammogram — it’s also linked to a higher risk of developing cancer.

Now, a cutting-edge study from researchers at Taizhou Cancer Hospital in China is showing how artificial intelligence (AI) can improve how we assess breast density — making screenings more accurate, consistent, and equitable.

The Research at a Glance

Using data from over 57,000 mammogram images taken from nearly 10,000 women, researchers trained deep learning models to classify breast density based on the BI-RADS system which includes four categories:

• Almost entirely fatty

• Scattered fibroglandular tissue

• Heterogeneously dense

• Extremely dense

The top-performing deep learning model, InceptionV3, demonstrated impressive accuracy, particularly for the more challenging “dense” categories — where traditional assessments by radiologists often vary.

Key Findings

High Accuracy: InceptionV3 achieved strong predictive performance across all categories, especially for “heterogeneously dense” and “extremely dense” tissue.

Consistency vs. Human Readers: While radiologists performed well on low-density classifications, their accuracy dropped significantly on higher-density cases — where the AI model excelled.

Equity and Generalizability: The model performed consistently across different imaging devices and racial groups, supporting its potential for fair, scalable deployment.

Why It Matters

Breast density affects both cancer detection and cancer risk — and the ability to correctly determine density can differ from one provider to the next. This variability can lead to missed diagnoses or unnecessary tests.

Implementing AI for breast density classification could:

•Standardize assessments

•Reduce human error and inter-reader differences

•Support personalized screening and follow-up based on risk

The Future of AI in Breast Imaging

This research suggests a future where AI tools assist radiologists directly, improving accuracy and enabling more confident decision-making — particularly in complex or high-risk cases.

As deep learning continues to evolve, we’re likely to see its integration into routine care, helping save lives through earlier detection and smarter screening strategies.

Learn More

• Listen to the AI on Air podcast episode

• Read the full study on Nature Scientific Reports

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WISDOM Study Launches Groundbreaking Research on Environmental Exposures and Breast Cancer Risk

Steffanie Goodman — Wed, 30 Apr 2025 20:59:45 +0000

WISDOM is conducting a pioneering research study to explore how women’s exposure to environmental toxins in the home and the workplace influence breast cancer risk. Supported by a grant from the U.S. Department of Defense, our new project, led by Dr. Kim Badal, is designed to find out whether adding environmental exposure information into WISDOM’s breast cancer risk models makes them more accurate. WISDOM uses breast cancer risk models (similar to a calculator) to determine a woman’s risk for breast cancer, and decide how often a person should be screened and what type of screening should be done (mammogram, or both mammogram and MRI). Incorporating information on a person’s exposure to environmental toxins could transform breast cancer prevention and early detection strategies.

Understanding the Environmental Impact

Up until now, breast cancer risk models rely on a person’s health history, and do not take into account a person’s exposure to environmental toxins. New evidence suggests that factors such as exposure to pollutants where you live and work can significantly impact breast cancer risk. For instance, studies have linked living in historically underserved or impoverished neighborhoods or working night shifts to increased incidences of aggressive breast tumors.

Innovative Research Approach

To delve deeper into these links, this new research study will be offered to current WISDOM participants.

We will invite participants to complete detailed questionnaires about their work and residential histories.
Then our researchers will add information from some external sources to the participants questionnaire responses in order to estimate environmental exposure over time.
In addition, they will analyze stored saliva samples to examine DNA methylation patterns or how cells label or tag certain parts of the DNA, which can affect which genes are turned on or off, like using sticky notes to mark important sections of a document. This analysis may reveal how environmental factors influence how genes are expressed in breast cancer.

Again, this approach could enhance the accuracy of breast cancer risk models.

WISDOM Participant Involvement

Current WISDOM participants will be invited to contribute to this study by completing two surveys:

Occupational History Questionnaire: Collects information about jobs held from age 18 to present, including job titles, industries, and length of time. It also asks about the participant’s mother’s job history during pregnancy, since in utero exposures may affect breast cancer risk.
Residential History Questionnaire: Gathers information on all places where the participant lived for more than six months since age 18, as well as the mother’s residences during pregnancy.

These two surveys are designed to be thorough yet still manageable for participants to complete. In a test group, it took participants between 15 to 90 minutes to complete the occupational history survey, and between 15 to 30 minutes to complete the residential history survey.

How this study will improve healthcare in the future

By including information about environmental exposures into future risk models, the WISDOM Study hopes to:

Make breast cancer risk assessment more accurate.
Identify women who may benefit from tailored screening and prevention strategies due to their increased risk.
Contribute to public health policies to reduce environmental risk factors associated with breast cancer.

This research holds promise for more personalized and equitable healthcare, particularly for members of communities more likely to be exposed to environmental pollutants.

This work is led by Dr. Kimberly Badal, Assistant Professor, Department of Surgery, UCSF, in collaboration with Dr. Peggy Reynolds and Dr. Robert Harrison from UCSF’s EaRTH Center. It is assisted by Olivia Cooper, Research Assistant at UCSF, UCSF Research Advocates Diane Heditsian, Susie Brain, and Vivian Lee who represent the patient perspective to study leaders, and Lianna Hartmour from ZERO Breast Cancer who is developing communication about the study for the general public. This project is sponsored by the United States Department of Defense.

To learn more, check out:

this interview with Dr. Badal where she talks about her research on the environment and breast cancer risk
WISDOM’s environmental research page (scroll to the bottom for helpful resources to learn more about the environment and your health)

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