WISDOM Trial Seeks to Personalize the Screening Process for Breast Cancer


The WISDOM trial seeks to determine if a personalized approach to screening for breast cancer is better than an annual mammogram.

As the breast cancer space moves towards the use of personalized medicine and targeted therapies, many argue that screening and prevention tactics are falling behind, which is why investigators in the WISDOM study are setting out to determine which approach to screening for breast cancer is the most effective: annual mammography or a modern personalized, risk-based approach.

The WISDOM Study is a five-year study comparing these two approaches and is free and open to all women between the ages of 40 and 74 who have not had breast cancer or DCIS. They are currently looking to enroll 100,000 women across the nation in the hopes of finding a more modern approach to breast cancer screening that can include more women and factors in risk prevention.

CURE® had the chance to speak with Dr. Laura Esserman, Director of the Carol Franc Buck Breast Care Center at the University of California, San Francisco and lead investigator of the national study, on the importance of modernizing the breast cancer screening process and what makes the WISDOM study unique.

CURE®: Can you provide some background on the trial?

Esserman: So, at the University of California, the five medical centers had gotten together to try and collaborate to take on some really big issues that we thought that we could really only do together.

I really felt like we needed to put forward a different paradigm where we talked about integrating screening and prevention, and really thought more about risk assessment as a way to think about screening. I think what all of us wanted to do was to try and take the lessons that we had learned from treating breast cancer, and all of the changes that had been made to advance the way we assign therapies (and) to try to figure out how we could apply that to the early detection setting.

In my experience, the people who are working on early detection are completely disconnected from the treatment of breast cancer and aren't even aware of all these changes. And we kind of felt like screening is stuck in this kind of one size fits all (scenario) while the treatment of breast cancer had really evolved and changed. But there was just no way to integrate these two worlds. So, we started by building this Athena Breast Health Network, which really became the platform upon which we built the WISDOM study.

What are the qualifications for the trial?

Very simple, you have to be between the ages of 40 and 74 without a prior breast cancer diagnosis, and that's it. You don't have to change your provider. You don't have to do anything different. You just have to be interested and want to join this whole movement that we hope will help us answer critical questions to help us figure out if there is a better way forward.

You just have to keep us filled in once a year about what's going on with them and letting us know if they have any biopsies, or if cancers are discovered, we actually would love to also try and profile as many of the tumors as possible so that we really understand who is at risk for what kind of cancer, because we feel like that is going to be the key to making future improvements and the key to helping us really change the paradigm for prevention.

What are you hoping to change with this trial?

I think we've seen that in cardiology, with cholesterol as being an early indicator of risk and something that can be brought down. We are lagging behind in that in breast cancer prevention, but there are emerging tools like breast density and whether or not that density goes down as an indicator of whether a certain medicine might work. We still need to do better on that, but we actually have tools at hand. And what we find is that when people really understand that they in fact have risk, then they're much more interested. And that's our point.

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