Laura Esserman, MD, MBA, leads the WISDOM study.
A national study evaluating a personalized approach to breast cancer screening and risk assessment has launched a new effort to diversify its participants, as it hits a milestone of 30,000 women enrolled.
The multiyear WISDOM study (Women Informed to Screen Depending on Measures of risk), led by UC San Francisco and the Athena Breast Health Network, will use a new, $9 million grant from the National Cancer Institute to increase ethnic diversity, as it works toward the goal of enrolling 100,000 or more women overall.
The study is being conducted nationwide in conjunction with five University of California medical centers, Sanford Health, and partners across the country.
Open to women between 40 and 74 who have not had breast cancer, the study evaluates two approaches to breast cancer detection: standard annual mammography, versus a personalized approach that takes multiple risk factors into consideration, including genetic markers and breast density, to make a recommendation about when to start or stop and how often to screen for breast cancer, and what type of imaging to use.
“We now know that all breast cancers are not the same – and today we don’t offer the same therapies for every woman,” said Laura Esserman, MD, MBA, director of the UCSF Carol Franc Buck Breast Care Center who leads the overall project. “This study tests the concept that one-size-fits-all might not be the right strategy for breast cancer screening and prevention either, especially because we know that all women do not have the same risk. Instead, we have developed an approach to determine how best to screen based on each woman’s risk, so we can do more for those at high risk, and less for those at lower risk.”
Despite continued advances in cancer care, approximately 42,000 women a year still die of breast cancer and about 1 in 8 U.S. women are expected to develop invasive breast cancer in her lifetime, according to Breastcancer.org. For American women, breast cancer death rates are higher than any other cancer except lung cancer.
Kim Rhoads, MD, MS, MPH
Associate Professor of Epidemiology & Biostatistics, UCSF; Director, Office of Community Engagement and Associate Director for Community Outreach and Engagement, UCSF Helen Diller Family Comprehensive Cancer Center
Risk assessment is particularly important among women of color, who are more at risk for lethal cancers. Even though women of color have slightly lower risk of getting breast cancer, they are 40 percent more likely to die of breast cancer than white women if they are diagnosed. In an effort to better identify those at highest risk in these communities, WISDOM has tapped Kim Rhoads, MD, MS, MPH, associate director for community engagement at the UCSF Helen Diller Family Comprehensive Cancer Center, to lead the national effort to recruit women across diverse backgrounds, ethnicities and geographic locations.
The effort will include partnerships with medical centers nationwide, including Louisiana State University, University of Chicago and Ingalls Memorial Hospital, in Illinois, University of Alabama, and Topline MD, in Florida.
“Minority women may be diagnosed with more aggressive breast tumors at younger ages,” said Rhoads. “Screening guidelines based on our understanding of breast cancer in white women may fail to achieve best outcomes in diverse populations. The WISDOM study will help us better understand the behavior of breast cancer in women of color, and tailor personalized and effective screening guidelines that will detect tumors easily and narrow a longstanding disparities gap.”