The debate between risk-based and annual mammography-based breast cancer screening continues, as recent research points to the former's benefits.
One study, which highlighted results from the Women Informed to Screen Depending on Measures of Risk (WISDOM) trial, suggested that it is safe to stratify screening intensity, modality, and age to start screening by individual risk. Imaging societies such as the American College of Radiology and the Society of Breast Imaging have pointed out methodological flaws in the study's design and said the results should not replace annual mammography screening.
In this episode, two researchers who are part of the WISDOM trial discuss the study's results and address criticism the study has received since it was published in December 2025. The researchers include Jeffrey Tice, MD, from the University of California, San Francisco, and Habib Rahbar, MD, from the University of Washington, Seattle.
Jeffrey Tice, MD, addresses criticism the WISDOM trial has received from imaging societies.
The researchers argue that risk-based screening could help women achieve better health outcomes. The WISDOM trial results showed that the risk-based approach reduces the rate of stage IIB or later breast cancer diagnoses. However, it did not make a significant difference in biopsy rates.
Proponents of risk-based screening say this approach can help with allocating appropriate resources to women at higher risk. Other proposed benefits to women include avoiding potential overdiagnosis and lessening anxiety.
Habib Rahbar, MD, clarifies the goals of the WISDOM trial, including seeking to improve upon current screening guidelines and not replace mammography screening altogether.
The researchers also talk about how emerging technologies like AI could help improve risk assessment even further. They also outlined future directions for the research, including the use of contrast and noncontrast MRI approaches and how risk-based screening could help promote equitable care.
See the full episode below:
